Study: Spinal fluid could be used to predict MS progression

May 15, 2018

A University of Birmingham study found that analysis of fluid in the spine could be used to predict future progression of multiple sclerosis. If the findings are confirmed, there would be a relatively simple test that could be used at diagnosis and help better determine treatment options.

The team of scientists analyzed the spinal fluid from patients with MS at the time they were diagnosed and matched these data with the progression of their disease five years later. The researchers found a highly unusual pattern in the behavior of white blood cells responsible for immunity and in the antibodies produced by these cells.

They found that the cells were producing a significantly higher ratio of one type of antibody molecule. These antibodies originated from cells within the nervous system of these patients – yet these cells are not normally found in this part of the body. In the blood of MS patients there is a normal ratio of around 2:1 of each type of antibody, but in the spinal fluid of the study's MS patients the researchers found ratios of more than 100:1.

The study’s authors said the research suggests that this early bias in this type of antibody could be related to a trigger of MS. For patients who later develop more severe disease they find that this attack by the immune system, even when analyzed at the time of diagnosis, has already developed beyond the initial trigger of the disease, resulting in greater damage to the nervous system in later years. The unusual pattern of antibody suggests a very distinct immune response early in the disease. The researchers are hoping to identify the target of this immune response.

The findings offer the opportunity to identify patients who are at higher risk of developing disability and may need more aggressive treatment. Similarly, it may be possible to identify patients at lower risk who may be able to manage their condition more conservatively. This will enable clinicians to justify the use of highly effective therapies, which could potentially improve the long-term outcomes for these patients.

The researchers said that more research was necessary to validate these research findings, including a study using a larger number of patients. The findings were published in the Journal of Neurology, Neurosurgery and Psychiatry.