Determining the current and future course of the autoimmune disease multiple sclerosis (MS) is important in order to slow down its course as much as possible. Now, researchers at the University of Basel have presented a biomarker whose values in the blood allow such predictions.

The findings are published in JAMA Neurology in an article titled, “Serum Glial Fibrillary Acidic Protein Compared With Neurofilament Light Chain as a Biomarker for Disease Progression in Multiple Sclerosis.”

“There is a lack of validated biomarkers for disability progression independent of relapse activity (PIRA) in MS,” wrote the researchers.

The team sought to determine how serum glial fibrillary acidic protein (sGFAP) and serum neurofilament light chain (sNfL) correlate with features of disease progression vs acute focal inflammation in MS and how they can prognosticate disease progression.

They focused on a cell component that is measurable in the blood and is characteristic of a certain type of brain cell. These cells, called astrocytes, play a key role in MS processes.

The new study by the research group led by Jens Kuhle, MD, PhD, professor, showed that elevated GFAP blood levels can indicate both current and future progression of MS.

Last year, the research team demonstrated that some patients with MS with an apparently stable disease course had high blood levels of the neurofilament light chain (NfL) biomarker. NfL specifically indicates neuronal damage.

These people had a significantly higher probability of presenting symptoms caused by MS in the following year. Since NfL sensitively predicts disease activity at an early stage, these patients can now be treated in a more targeted, proactive manner.

Compared with NfL, the GFAP blood marker allows conclusions to be drawn about a different aspect of the complex pathophysiology of MS. Although increased NfL blood values indicate neuronal damage, GFAP in blood specifically indicates chronic disease processes in which astrocytes are involved and that contribute to gradual progressive disability.

“GFAP and NfL thus complement each other,” said Kuhle. “They can help us in making MS therapy more individually tailored and forward-looking.” These outcomes of biomarker research bring both potential therapy monitoring and prognosis, as well as research on disease origins, a big step forward.

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