New Blood Test May Detect Multiple Sclerosis Worsening

A novel blood test may be able to predict whether patients with multiple sclerosis (MS) will experience a flare-up, according to a study published by Neurology Neuroimmunology and Neuroinflammation.

The test monitors a nerve protein in the blood called the neurofilament light chain, which is a part of nerve cells. When the cells die, the protein can be detected in the blood and spinal fluid, according to the study authors.

“Since MS varies so much from person to person and is so unpredictable in how the disease will progress and how people will respond to treatment, identifying a biomarker like this that can help us make predictions would be very helpful,” said author Kristin N. Varhaug, MD. “These blood tests could provide a low-cost alternative to MRI for monitoring disease activity.”

The authors said that this test may be especially useful for patients with relapsing-remitting MS (RRMS) who are fearful of MRI scans, which are typically used to detect disease progression, according to the study.

“We monitored neurofilament light chain levels in the blood of people with the relapsing-remitting form of MS and found levels of this nerve protein were higher when people had new disease activity and lower when they took medication to reduce the number of symptom flare-ups,” Dr Varhaug said.

Included in the study were 85 patients with RRMS who were diagnosed an average of 2 years prior. Patients did not receive disease-modifying therapy for the first 6 months, which was followed by treatment with interferon-beta 1a for the following 18 months. Interferon-beta 1a can reduce the prevalence of flare-ups and brain lesions.

Patients also received monthly MRI scans for the initial 9 months and then received MRI scans at 1 year and 2 years. Blood samples were gathered at baseline, 3 months, 6 months, 1 year, and 2 years.

The authors discovered that the blood levels of the nerve protein were higher when the MRI scans showed new T1 and T2 lesions, according to the study. These lesions are areas of brain damage caused by MS.

Patients with newly-developed T1 lesions were observed to have 37.3-picograms per milliliter (pg/ml) of the protein in their blood compared with 28-pg/ml for patients without new lesions, according to the study.

Additionally, patients with new T2 lesions had 37.3-pg/ml of the protein in their blood compared with 27.7-pg/ml for patients without new lesions.

Notably, high nerve protein levels were persistent for 3 months during the development of new lesions, according to the study.

However, protein levels were observed to decrease when interferon treatment was initiated, further confirming the efficacy of this therapy for MS.

The authors discovered that that an increase of 10-pg/ml in the protein was linked to a 48% increased risk of new T1 lesions and a 62% increased risk of T2 lesions, according to the study.

These results suggest that a simple, non-invasive test may be able to help patients with MS control their disease. It may also help physicians determine whether interferon therapy is working.

“Blood tests for this nerve protein may be an effective way to monitor disease activity and how well the treatment is working,” Dr Varhaug said.