Multiple sclerosis -key biomarkers that predict disability discovered

A pioneering study presented today at ECTRIMS 2024 has identified critical biomarkers that can predict disability worsening in multiple sclerosis
A pioneering study presented has identified critical biomarkers that can predict disability worsening in multiple sclerosis.


His breakthrough research can potentially transform treatment strategies for millions of MS patients worldwide, paving the way for more personalised and effective treatment plans.

In a multicenter observational study conducted across 13 hospitals in Spain and Italy, Dr. Enric Monreal and his team discovered that elevated serum neurofilament light chain (sNfL) levels, a protein indicating nerve cell damage at the onset of MS, can predict both relapse-associated worsening (RAW) and progression independent of relapse activity (PIRA). Furthermore, they found that serum glial fibrillary acidic protein (sGFAP) levels, a protein derived from astrocytes that enter the bloodstream when the central nervous system (CNS) is injured or inflamed, correlate with PIRA in patients with low levels of safety.

Key findings reveal that higher sNfL levels, indicative of acute inflammation within the CNS in MS, are associated with a 45% increased risk of RAW and a 43% increased risk of PIRA. Patients with high sNfL levels often did not respond well to standard disease-modifying treatments (DMTs) but showed significant benefits from high-efficacy DMTs (HE-DMTs) such as Natalizumab, Alemtuzumab, Ocrelizumab, Rituximab, and Ofatumumab.

In contrast, patients with high sGFAP levels—which indicate more localised inflammation driven by microglia in the CNS—and low sNfL levels experienced an 86% increased risk of PIRA. This group did not respond to current DMTs.

Interestingly, while sGFAP is known to be associated with progression, high sNfL levels limited the ability of sGFAP to predict this outcome. Specifically, sGFAP values were predictive of PIRA only in patients with low sNfL levels.“”The discovery of sNfL and sGFAP as predictive biomarkers enables us to customize treatment plans for MS patients more effectively,” says Dr. Monreal, a researcher in MS at Ramón y Cajal University Hospital and the study’s lead author. “Patients with low levels of both biomarkers have a positive prognosis and can be treated with injectable or oral DMTs. However, high sNfL levels indicate a need for HE-DMTs to prevent disability progression, while patients with high sGFAP levels and low sNfL values may require new therapeutic approaches. These distinct pathways in MS have significant therapeutic implications, as current DMTs primarily target the peripheral adaptive immune system without affecting CNS immunity. Therefore, identifying patients with higher levels of peripheral inflammation is crucial for preventing disability and improving patient outcomes.”

“The results of this study underscore the critical need for personalised treatment approaches to effectively manage the millions of people affected by MS worldwide, many of whom have chronic disability that significantly impacts their quality of life,” says Dr. Monreal.

“By measuring both sNfL and sGFAP levels at disease onset, we gain valuable insights into the progression pathways of MS, enabling clinicians to identify the optimal patients for specific DMTs. This approach aims to prevent disability while avoiding unnecessary treatment-related risks for those at lower risk.”

Biomarkers in fathers’ sperm linked to offspring autism

Biomarkers in fathers sperm linked to offspring autism
Biomarkers in fathers sperm linked to offspring autism


 Biomarkers in human sperm have been identified that can indicate a propensity to father children with autism spectrum disorder. These biomarkers are epigenetic, meaning they involve changes to molecular factors that regulate genome activity such as gene expression independent of DNA sequence, and can be passed down to future generations.

In a study published in the journal Clinical Epigenetics on Jan. 7, researchers identified a set of genomic features, called DNA methylation regions, in sperm samples from men who were known to have autistic children. Then in a set of blind tests, the researchers were able to use the presence of these features to determine whether other men had fathered autistic children with 90% accuracy.

“We can now potentially use this to assess whether a man is going to pass autism on to his children,” said Michael Skinner, professor of biological sciences at Washington State University and corresponding author on the study. “It is also a major step toward identifying what factors might promote autism.”

Incidence of autism spectrum disorder has increased dramatically over time from 1 in 5,000 people in 1975 to 1 in 68 in 2014. While improved diagnosis and awareness can account for some of that change, many researchers believe the recent increase over the last two decades may be due to environmental and molecular factors. Previous studies have also shown that children can inherit the disorder from their parents, and that fathers are more often linked to autism transmission than mothers.

In the current study, researchers from WSU, Valencia Clinical Research Center and Valencia University in Spain, looked at sperm epigenetics, the molecular processes that affect gene expression, in two groups of men: 13 who had fathered sons with autism, and 13 who had children without the disorder. They looked specifically at DNA methylation, a chemical modification that happens when a methyl group attaches to a DNA strand and can turn genes on or off.

The researchers identified 805 different DNA methylation regions that can potentially act as an epigenetic biomarker for susceptibility to father offspring with autism. They tested their findings by attempting to identify fathers who did or did not have autistic children just from their sperm samples. In blind tests of 18 men, they correctly identified all the fathers, except for two false negatives, an accuracy rate of about 90%.

More work and expanded trials need to be done to develop the study’s findings into a potential medical tool, and Skinner and his colleagues are working on a more extensive study involving more than 100 men.

With further research, this biomarker could also be used to trace how the epigenetic changes occurred in the first place, said Skinner.

“We found out years ago that environmental factors can alter the germline, the sperm or the egg, epigenetics,” said Skinner. “With this tool we could do larger population-based studies to see what kinds of environmental factors may induce these types with epigenetic changes.”