Blood test detects multiple sclerosis years before it develops

This discovery, published in the journal Nature Medicine, opens up promising opportunities for early detection and could revolutionize the treatment of this disease.

In about 10% of cases of multiple sclerosis, the body begins to produce specific antibodies against its own proteins long before symptoms become obvious. These autoantibodies bind to both human cells and common pathogens, potentially explaining the immune attacks in the brain and spinal cord that characterize multiple sclerosis.

“Identifying this autoimmune signature in the blood could revolutionize the way we treat multiple sclerosis.says Michael Wilson, lead author of the study and a neuroscientist at UCSF. “With early detection, we can intervene earlier, offering patients a better quality of life.”

As Enric Monreal, Ramon y Cajal University Hospital and member of the Ramon y Cajal Institute for Medical Research, explains, the causes of multiple sclerosis, an autoimmune disease and the second cause of disability in young people, are not fully known. “Recognized genetic predispositionwhich is influenced by environmental factors, among which are viral infections, for example, those caused by the Epstein-Barr virus.

This study, as reported by Science Media Center, attempts to delve deeper into the processes that occur in the years before symptoms of multiple sclerosis appear. It uses the same database of 10 million US military patients from which another paper was published in the prestigious journal Science in 2022, seeking to deepen the relationship between the Epstein-Barr virus (which causes infectious mononucleosis, also known as the Epstein-Barr virus). Barra”). kissing disease”) and MS.

The research used advanced technology to analyze blood samples from people who later developed multiple sclerosis. Using a technique called phage immunoprecipitation sequencing (PhIP-Seq), which detects autoantibodies against thousands of human proteins, they identified consistent features in those who developed the disease.

The team examined blood samples collected from military personnel several years before and after their multiple sclerosis diagnosis. Surprisingly, they found an abundance of autoantibodies in a subset of people, indicating a possible early indicator of multiple sclerosis.

More precisely

Subsequent analysis of blood samples from patients participating in the UCSF ORIGINS study confirmed the presence of this autoantibody pattern with 100% predictability for the diagnosis of multiple sclerosis. This discovery promises more accurate and timely diagnosis, facilitating discussion of treatment options.

“Although many questions about multiple sclerosis remain unanswered, this study represents an important step in our understanding of the disease,” says Steven Houser, director of the Weill Institute for Neuroscience at the University of California, San Francisco and senior author of the paper.

Ana Belen Caminero Rodriguez, coordinator of the GEEMENIR group of the Spanish Society of Neurology and leader Neurology Department of the Avila Medical Complex, The study fits perfectly with the results of previous studies.

First, he points out about SMC, “there is a presymptomatic or preclinical period of the disease, lasting several years, during which the patient does not yet have the typical symptoms of multiple sclerosis, but experiences other, more nonspecific symptoms.” , prodromal symptoms, during which an inflammatory process in the central nervous system may already develop. Nevertheless, very few patients who was diagnosed with the disease at these stages.

On the other hand, “this allows us to cement the importance of EBV in the development of multiple sclerosis. Two years ago, another large study was published that also demonstrated in the same group of US military personnel that the risk of multiple sclerosis increased 32-fold after infection with EBV, but not after infection with other similarly transmitted viruses, such as cytomegalovirus. “Today it is the most important and consolidated risk factor.”

In his opinion, the most important consequence of this is that when studying this immunological fingerprint “subjects at risk of developing multiple sclerosis can be detected in subsequent years, start disease-modifying treatment as early as possible and implement all measures aimed at preventing the accumulation of disability.

Moreover, he continues, “the development of an effective vaccine against EBV could potentially prevent this disease if it were administered before the subject was infected with the virus. “In addition, the results of this study open up new opportunities to improve health outcomes for patients with multiple sclerosis.”

Not all patients are the same

The study, says Luis Querol Gutiérrez from the Santa Creu i Sant Pau Hospital and researcher at the Sant Pau Institute of Biomedicine in Barcelona, ​​has several important implications for the understanding of the disease and the continuation of research, although I believe they are currently not feasible in clinical practice. “First, it seems clear that not all patients are the same from an immunological point of view. This is something we have already felt for other reasons, but the study confirms it. “This probably means that, in terms of mechanisms and causes, MS is not a disease, but a group of diseases that are very similar in their presentation, but have different mechanisms.”

Another important implication that was also known “is that there may be external pathogens (primarily Epstein-Barr virus) that, although not the sole cause, may play a role as triggers in predisposing disease. Population.” “.

Montreal cautions, however, that there is no immediate chance that these autoantibodies will be measurable in clinical practice in the short or long term.