Michigan’s Memorial Healthcare First in US to Test NfL in MS Patients

Michigan’s Memorial Healthcare First in US to Test NfL in MS Patients

Memorial Healthcare Institute for Neurosciences and Multiple Sclerosis announced it will become the first U.S. hospital to test a nerve cell-derived component known as neurofilament light chain (NfL) in multiple sclerosis (MS) patients.

Led by the Owosso, Michigan, hospital’s chief of neurology and MS director, Rany Aburashed, DO, the study aims to investigate NfL as a disease biomarker in 1,000 patients. The overarching goal is to learn how NfL can help predict MS progression and measure treatment effectiveness.

“NfL has the potential to dramatically increase our ability to assess disease activity and change in real time,” Aburashed said in a press release.

“Previous testing of NfL was limited to spinal fluid only, which remains impractical in the clinical setting. We are optimistic that this testing can hopefully help us determine the degree of underlying structural damage occurring from a condition. In turn, we hope we can also assess whether our treatments are effectively working using NfL,” Aburashed said.

NfL is a protein associated with nerve cell damage. Brain or spinal cord injuries cause levels of the polypeptide to leak into spinal fluid and blood. Such levels increase with the degree of axonal damage in a host of neurological disorders, including Alzheimer’s and dementia, which can help target individual patient treatment.

Evidence is mounting that NfL levels are increased in the blood and cerebrospinal fluid of MS patients. In fact, a recent investigation showed the protein’s potential as a biomarker in relapsing-remitting MS.

Currently, brain cell damage or loss in MS patients is measured using MRI. But that technique is expensive, hard to standardize, and requires intricate post-exam analysis. A more affordable, less-complicated biomarker could have a dramatic effect on the long-term monitoring of MS in both clinical practice and clinical investigations.

“A patient’s presentation, degree of disability and symptoms all make up a unique fingerprint to their disease,” said Aburashed. “Given these differences, there is currently no standardized algorithm for treating MS. However, we are cautiously optimistic to learn the potential value of measuring NfL and, in turn, hopefully be able to provide more accurate treatment regimens on an individual level and much earlier in the disease course,” he said.

In a related development, new data suggest that measuring NfL blood levels potentially could help identify those who have early MS but are pre-symptomatic. In the study, investigators found raised levels of NfL in blood samples collected six years before individuals were diagnosed with MS. The study used the highly sensitive Simoa NF-light assay, a molecular technology recently developed to measure NfL in blood samples.

Memorial Healthcare is building a comprehensive neurology program. Apart from the investment on NfL technology, the institute also investing in a new facility focused on neurology and orthopedics.

“Our goal and primary focus remains entirely on helping the individual patient in front of us, while providing the best possible collaborative framework to achieve our full potential both as care providers and as a team,” Aburashed said.

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Patrícia holds her PhD in Medical Microbiology and Infectious Diseases from the Leiden University Medical Center in Leiden, The Netherlands. She has studied Applied Biology at Universidade do Minho and was a postdoctoral research fellow at Instituto de Medicina Molecular in Lisbon, Portugal. Her work has been focused on molecular genetic traits of infectious agents such as viruses and parasites.
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    • Dr. Rany Aburashed says:

      Hi Rosanne, the testing is not FDA approved at this time and remains strictly investigational. Saying that, our hope is that by driving the technology into an active MS center and seeing the biomarkers behavior under the stresses of a variety of patients with other diseases (HTN, diabetes, smoking etc) we will be able to expedite and answer some of the questions that still surround the technology. At the bench level, we are much closer to understanding some of the nuance surrounding the testing. The question we continue to push to answer is how does this hold up in a real world setting? How does the testing correlate to the patient in front of us? Is there any correlation between the testing and Quality of life? Amongst many others.

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