2024-04-19 13:23:28
Multiple sclerosis (MS) can be detected in people’s blood years before symptoms appear. Scientists at the University of California, San Francisco (UCSF) have found specific antibodies in the blood of patients years before they appear multiple sclerosis symptoms. This group of antibodies was present in 10% of the 250 people who later developed the disease, who were part of a sample of more than 10 million US military personnel.
This finding, published in ‘Nature Medicine’, offers a promising avenue for early detection and can revolutionize the treatment of the disease.
In about 10% of MS cases, the body begins to produce distinctive antibodies against its own proteins long before symptoms become evident. These autoantibodies bind to both human cells and common pathogens, potentially explaining the immune attacks in the brain and spinal cord characteristic of MS.
«Identifying this autoimmune signature in the blood could revolutionize how we approach MS treatment» says Michael Wilson, lead author of the study and a neurologist at UCSF. “With early detection, we can start interventions sooner, offering patients a better quality of life.”
Explains Enric Monreal, Ramón y Cajal University Hospital and member of the Ramón y Cajal Institute for Health Research, the causes of MS, an autoimmune disease and the second cause of disability in young individuals, are not completely known. «It is recognized a genetic predispositionwhich is influenced by environmental factors, among which viral infections stand out, such as that caused by the Epstein-Barr virus.
This study, tells Science Media Center, attempts to delve deeper into the processes involved in the years before the onset of symptoms in MS. It uses the same database of US military service patients (10 million) with which another work was published in 2022 in the prestigious journal Science, which sought to deepen the relationship between the Epstein-Barr virus (causing infectious mononucleosis, also known as “the kissing disease”) and MS.
With early detection, we can begin interventions sooner, offering patients a better quality of life
Research has used advanced technology to analyze blood samples from people who later developed MS. Using a technique called phage immunoprecipitation sequencing (PhIP-Seq), which detects autoantibodies against thousands of human proteins, they identified a consistent signature in those who developed the disease.
The team examined blood samples collected from military personnel years before and after their MS diagnosis. Surprisingly, they found an abundance of autoantibodies in a subset of individuals, indicating a possible early indicator of MS.
More precise
Subsequent analysis of blood samples from patients in the UCSF ORIGINS study confirmed the presence of this autoantibody pattern, with 100% predictability for the diagnosis of MS. This discovery offers the promise of more accurate and timely diagnosis, facilitating discussions about treatment options.
“Although many questions about MS remain unanswered, this study represents a critical step in our understanding of the disease,” says Stephen Hauser, director of the Weill Institute for Neurosciences at UCSF and senior author of the paper.
For Ana Belén Caminero Rodríguez, coordinator of the GEEMENIR group of the Spanish Society of Neurology and head of Neurology Section of the Ávila Healthcare Complex, The study fits perfectly with the results of previous studies.
Firstly, he points out to SMC, “there is a pre-symptomatic or pre-clinical period of this disease, lasting several years, during which the patient does not yet have the typical symptoms of MS, but does have other more non-specific, prodromal symptoms, during which an inflammatory process may already be developing within the CNS. Nevertheless, there are very few patients to whom the diagnosis of the disease is made in these phases.
EBV is today the most important and consolidated risk factor for MS
On the other hand, “it allows us to consolidate the importance of EBV in the development of MS. Two years ago, another large study was published that also demonstrated in the same cohort of US military personnel that the risk of MS increases 32 times after EBV infection and not after other viruses that are transmitted in a similar way, such as cytomegalovirus. “It is today the most important and consolidated risk factor.”
In his opinion, the most important consequence of this is that, with the study of this immunological fingerprint, «subjects at risk of developing MS could be detected in the following years to initiate disease-modifying treatments as early as possible and implement all those measures aimed at avoiding the accumulation of disability.
Furthermore, he continues, “the development of an effective vaccine against EBV could potentially prevent this disease, if applied before the subject has been infected by the virus. Furthermore, the results of this research open new avenues to improve health outcomes for patients with MS.”
Not all patients are the same
The research, says Luis Querol Gutiérrez, from the Hospital de la Santa Creu i Sant Pau and researcher at the Institut de Recerca Biomèdica Sant Pau in Barcelona, has several relevant implications for understanding the disease and for continuing research, although, I believe, they are not currently implementable in clinical practice. «The first is that it seems clear that not all patients are the same immunologically. This is something that we already sensed for other reasons, but the study reconfirms it. “This probably means that, from the point of view of mechanisms and causes, MS is not a disease, but a group of diseases that are very similar to each other in their manifestations but have different mechanisms.”
The other important implication, which was also known, “is that it is possible that there are external pathogens (the Epstein-Barr virus, above all) that, although they are not the only cause, can play a role as triggers in a predisposed population.” ».
Monreal, however, warns that there is no near prospect that these autoantibodies can be measured in clinical practice in the short or long term.
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