Tampons could offer way to monitor multiple sclerosis nerve damage
Study: Noninvasive method detects potential biomarker in menstrual fluid
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Sample collection tubes are shown in a laboratory. (Photo by iStock)
- Tampon-collected menstrual fluid can detect neurofilament light chain (NfL), a nerve damage biomarker.
- This noninvasive method could help monitor multiple sclerosis activity and treatment response.
- NfL levels in menstrual fluid correlate with estrogen, suggesting biological significance.
Menstrual fluid collected from tampons could one day provide a simple, noninvasive way to measure a biomarker of nerve damage and potentially track disease activity in neurological conditions such as multiple sclerosis (MS).
Researchers at Nextgen Jane, in collaboration with Siemens Healthineers, found that neurofilament light chain (NfL) — a protein released when nerve cells are damaged — can be reliably detected in tampon-collected menstrual samples, Nextgen Jane announced in a company press release.
Because NfL has emerged as a promising biomarker of MS, detecting it in menstrual fluid raises the possibility of monitoring disease activity simply by leveraging the natural monthly sampling cycle of menstruation.
The companies presented the findings in a poster, titled “Tampon-based Menstrual Fluid Sampling Enables Non-Invasive Detection of Neurological, Hormonal, and Inflammatory Biomarkers,” at the American Academy of Neurology annual meeting held in Chicago last month.
Protein shows promise for detecting MS
In MS, the immune system mistakenly attacks healthy parts of the brain and spinal cord, causing inflammation and damage that can lead to symptoms such as fatigue, numbness, muscle weakness, and problems with balance or vision.
Confirming a diagnosis of MS usually requires a combination of physical and neurological examinations, MRI scans to assess for brain and spinal cord damage, and lab tests. These include detecting certain proteins in cerebrospinal fluid (CSF), the fluid that surrounds the brain and spinal cord, which may indicate inflammation in the brain or spinal cord.
After diagnosis, patients are usually monitored through clinical assessments and routine MRI scans, which allow doctors to detect changes in disease activity and determine whether treatments are working.
However, MRI assessments can be costly and are usually done once or twice a year, which prevents doctors from detecting early changes and making timely treatment adjustments.
Because of these challenges, researchers have long sought cost-effective, more readily accessible biomarkers that could help detect MS earlier, monitor disease activity over time, and evaluate treatment response.
One of the most promising candidates is NfL, a protein found in nerve cell fibers that is released into the bloodstream and CSF upon nerve cell injury.
NFL detected in 98 of 99 menstrual fluid samples
Studies have shown that NfL levels are elevated in the blood and CSF of MS patients, and correlate with markers of disease activity and response to treatment, supporting its potential as a biomarker of the disease.
To explore whether menstrual fluid could serve as a source for detecting such a biomarker and, more broadly, as a noninvasive specimen for monitoring neurological, hormonal, and inflammatory signals, researchers at Nextgen Jane analyzed 99 tampon-collected menstrual fluid samples from 91 participants.
They used Siemens Healthineers’ highly sensitive NfL assay on its automated testing platform. The team also measured hormonal and inflammatory molecules.
NfL was detected in 98 of the 99 menstrual fluid samples analyzed, suggesting the biomarker can be reliably measured in tampon-collected samples. They also found that NfL levels were associated with estradiol levels, a form of the hormone estrogen, and that this relationship remained significant even after adjusting for differences in blood content between samples.
Finding that NfL tracks with estrogen levels in menstrual fluid, independent of how much blood is in the sample, tells us there is real biology here, not just contamination. That changes what this specimen means for neurology.
By comparison, levels of inflammatory markers were more strongly linked to blood content itself. These findings suggest that NfL detection was not merely the result of blood contamination, but may reflect biologically meaningful changes that could potentially be tracked over time through routine menstrual sampling, according to the researchers.
“Finding that NfL tracks with estrogen levels in menstrual fluid, independent of how much blood is in the sample, tells us there is real biology here, not just contamination,” said Ridhi Tariyal, CEO and co-founder of Nextgen Jane. “That changes what this specimen means for neurology.”
Building on these findings, Nextgen Jane is now planning prospective studies to investigate whether menstrual NfL and other neurological proteins can be used to track disease activity over time in conditions such as MS.
“The menstrual cycle provides a built-in longitudinal framework: the same individual, the same biological process, month after month,” said Stephen Gire, chief scientific officer at Nextgen Jane. “Coupling the NextGen Jane platform with Siemens Healthineers’ highly sensitive NfL assay gives us a path to study neurological biomarker trajectories in a way that has not been possible before.”
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