Higher-than-usual levels of specific antibodies in the blood of patients with clinically isolated syndrome (CIS) may predict a faster progression to multiple sclerosis (MS), an Australian study reports. The specific antibody is known as IgG3, an immunoglobulin known to promote inflammation.
The study, “Higher Serum Immunoglobulin G3 Levels May Predict the Development of Multiple Sclerosis in Individuals With Clinically Isolated Syndrome,” was published in the journal Frontiers in Immunology.
CIS is a first episode — one lasting at least 24 hours but typically followed by full recovery — of neurological symptoms caused by inflammation and the loss of myelin, the protective layer of nerve fibers. CIS is known to often precede the development of MS, a progressive disease marked by the immune system attacking myelin in the central nervous system (the brain and spinal cord).
Diagnosing this condition currently includes imaging scans (MRIs) to check for evidence of CNS inflammation and demyelination (lesions), and blood tests to rule out other possible causes of the symptoms experienced, which can range from vision problems (optic neuritis), to muscular weakness or extreme nausea.
No reliable biomarkers exist to that might guide prognosis, or likely outcomes, in a person with CIS, the study noted, only historical knowledge that an earlier age at CIS onset and evidence of multiple lesions (nine or more) on an MRI scan are associated with a high risk of conversion to MS.
Blood biomarkers that help to predict the likely length of time to such conversion would be of considerable value, especially in allowing for better and more timely treatment decisions.
Increasing evidence has shown that B-cells — a type of white blood cell that produces antibodies against pathogens and is involved in inflammatory responses — are critical players in MS development.
Both CIS or MS patients have B-cells in the cerebrospinal fluid — the fluid that fills the brain and spinal cord – a hallmark of central nervous system inflammation and one associated with brain lesion severity. But while changes in the levels of specific antibodies have been associated with other inflammatory neurodegenerative disorders, no MS-specific antibodies have been identified so far.
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