AAN 2025 | The combination of CSF and serum biomarkers to predict disease worsening in MS
Enric Monreal, MD, PhD, Ramón y Cajal Hospital, Madrid, Spain, comments on a study investigating the predictive value of the combination of cerebrospinal fluid (CSF) and serum biomarkers at disease onset in multiple sclerosis (MS). The study assessed several biomarkers, including intrathecal IgM, neurofilament, and glial fibrillary acidic protein (GFAP), to predict disability worsening in MS. The study found associations between these biomarkers and immune mechanisms, providing insights into the predictive value of biomarkers at disease onset. This interview took place at the 77th American Academy of Neurology (AAN) Annual Meeting in San Diego, CA.
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Transcript
That was a study we performed in Spain that was a multi-center study. We aimed to assess several biomarkers that have been already described in multiple sclerosis, ones in the CSF, such as intrathecal IgM synthesis, others in the serum, such as neurofilament and GVAP. And we wanted to combine them to see whether they could predict disability worsening in multiple sclerosis...
That was a study we performed in Spain that was a multi-center study. We aimed to assess several biomarkers that have been already described in multiple sclerosis, ones in the CSF, such as intrathecal IgM synthesis, others in the serum, such as neurofilament and GVAP. And we wanted to combine them to see whether they could predict disability worsening in multiple sclerosis. We performed it. It was a multi-center study that we did it at disease onset. We included only MS patients in which sample obtainment was within the first year of disease. And we wanted to see whether they could predict disability worsening and they were associated either with relapsed-associated worsening or progression independent of relapsed activity. We found that neurofilaments and IgM synthesis were mainly associated with inflammation, that is, RAW and active PIRA, and GVP was mainly associated with non-active PIRA. And we also wanted to assess whether the mechanism associated, and we found that, for example, inflammation, that is, for example, increased neurofilaments were mainly associated with lower T regulatory cells in the CSF, especially in those with IgM positive. And also we analyzed in those without IgM and we found that they were positively correlated with the complement levels in the CSF.
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