Researchers have discovered that an elevated level of neurofilament light chain (NfL), a biomarker of nerve damage, can predict the deterioration of multiple sclerosis (MS) disability up to two years before symptoms occur. This biomarker offers a timeframe during which interventions can be implemented to prevent or slow down the progression of disability.
MS is believed to be an autoimmune disorder in which the immune system attacks the protective covering of nerves called myelin. The symptoms of MS can vary and are often unpredictable, with varying severity and duration. However, researchers at the University of California, San Francisco (UCSF) have found that increased levels of NfL can provide early indications of MS worsening up to two years before disability manifests. This study is the first to quantify the time frame preceding disability deterioration in MS.
Ahmed Abdelhak, the lead author of the study, stated that the rising levels of NfL up to two years before signs of disability worsening establish a treatment window during which interventions have the potential to prevent further deterioration.
In collaboration with the University of Basel in Switzerland, the researchers examined disability progression, categorized as either disability worsening with relapse or gradual progression of symptoms without relapse. Disability worsening was defined as a period of six months or longer with increased impairment, as indicated by higher scores on the Expanded Disability Status Scale. The researchers analyzed data spanning a decade from two studies that included a total of 1,899 patients. Among them, 570 individuals experienced worsening disability in MS, with the majority of cases independent of relapses.
The study revealed that elevated NfL levels were associated with up to a 91% higher risk of disability worsening with relapse approximately a year later and up to a 49% higher risk of disability worsening nearly two years later. Abdelhak suggested that NfL elevation occurs earlier in disability worsening without relapse, indicating that healthcare providers may have the opportunity to intervene in the slow progression of the disease.
Ari Green, one of the co-authors of the study, emphasized that the findings support the understanding that nerve cell death is a gradual process leading to permanent disability. This knowledge implies that interventions to protect nerve cells might have the potential to halt disability progression.
These findings underscore the importance of utilizing NfL as an early marker for nerve damage. Jens Kuhle, another co-author, stated, “In addition to the groundbreaking findings on the temporal relationship between NfL increases and gradual disease progression in MS, the study supports the important role of NfL as an early marker of nerve damage.” Monitoring NfL levels could potentially detect disease activity with higher sensitivity than clinical examinations or conventional imaging.
Further research is necessary to explore therapies that could effectively prevent the progression of MS during the period of elevated NfL levels. This knowledge can contribute to improved treatment strategies and better outcomes for individuals with MS.
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- Source: Coherent Market Insights, Public sources, Desk research
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