The results also show that regeneration is unaffected by treatment with disease-modifying therapies (DMTs), as shown by the levels of a regeneration marker in the brain called growth-associated protein 43.
The study, “Cerebrospinal fluid growth-associated protein 43 in multiple sclerosis,” was published in the journal Nature Scientific Reports.
In MS, immune cells attack the myelin sheath that protects nerves, leading to neurodegeneration. In early disease stages, regenerative mechanisms are activated to help repair damaged tissue and promote the replacement of lost myelin — a process called remyelination.
Growth-associated protein 43 (GAP-43), also called B-50 or neuromodulin, is a surface protein found at the immature synaptic terminals — the junctions between two nerve cells that allow them to communicate — and in growing axons, which are the long projections of a nerve cell that conduct electrical impulses away from the cell body to other nerve cells, muscles, and glands.
For this reason, “GAP-43 is widely used as a marker of neuronal growth and regeneration,” the researchers said.
Previous research reported that GAP-43 levels correlate negatively with the expanded disability status scale (EDSS), a method of quantifying disability in MS patients. Higher EDSS scores indicate more disability. This means that lower GAP-43 levels correlated with greater disability. In fact, lower levels of GAP-43 were found in secondary progressive MS (SPMS) compared with early stages of MS.
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