Multiple Sclerosis: Can a Blood Test Detect MS Years Before Symptoms Appear? New Research Encouraging

New clinical trial findings could advance the early treatment for patients with multiple sclerosis (MS) before debilitating symptoms develop. Researchers at UC (University of California) San Francisco have found “a harbinger in the blood of some people who later went on to develop the disease,” states a news release from UCSF.

In about 1 in 10 cases of MS, the body begins producing a distinctive set of antibodies that fight a person’s own proteins years before symptoms emerge. These autoantibodies may explain the immune attacks on the brain and spinal cord behind MS.

While the findings of this new study, published in Nature Medicine, potentially advances the development of early detection, more research is needed before such a blood test would be widely available, explains Amy Yu, M.D., director of the Multiple Sclerosis and Immunology Program at Marcus Neuroscience Institute at Boca Raton Regional Hospital. 

“This study identified an MS-specific autoantibody signature,” said Dr. Yu. “This is a very interesting finding because it allows clinicians to assess for even earlier MS detection. It is well recognized that sometimes, prior to the onset of clinical MS, there may be an ‘MS prodrome’ where patients may experience a range of nonspecific symptoms without a clear demyelinating event (damage to the protective covering that surrounds nerve fibers).”

Once Diagnosed, MS Patients have Treatment Options

Neuroimmunologist Amy Yu, M.D., medical director of Multiple Sclerosis and Neuroimmunology at Marcus Neuroscience Institute at Boca Raton Regional Hospital, part of Baptist Health.>

There’s no cure yet for MS, which can lead to a devastating loss of motor control. But treatment advances are slowing progress of the most aggressive form of the disease, and research findings continue to offer hope to more patients. Once diagnosed, MS patients have more medical treatments available than ever.

“The study identified serum markers that could identify those at the highest risk of developing MS,” explains Dr. Yu. “There are many researchers working on establishing tools for preclinical MS, to allow for earlier detection, and maybe even prevention of clinical MS. However, this remains within the research realm for now but hopefully can become clinically available in the future.” 

Serum refers to the clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. While the new findings are encouraging, Dr. Yu does emphasize that the there are several risk factors for developing MS that can help clinicians diagnose a higher-than-normal risk of MS. 

Many Risk Factors are Linked to MS

“I would interpret this study with caution,” said Dr. Yu. “The main risk factors for developing MS include having a first-degree relative with MS or other autoimmune diseases; a history of infectious mononucleosis; low vitamin D levels; and a few other environmental risk factors. If there are neurological symptoms with a positive family history, it is reasonable to consult with a neurologist and have and an MRI brain completed.”

Dr. Yu adds that even if a person has risk factors for developing MS, many do not ultimately develop MS. It is currently estimated that first-degree relatives of those with MS have only a 4 percent risk of developing MS, she said.

Currently, early testing for MS, especially in preclinical or pre-symptomatic states, include the MRI of the brain and a thorough neurological examination. In certain cases, serum biomarkers can be detected One particular biomarker used by the researchers in this study was the serum neurofilament light (sNFL), which can be elevated prior to onset of clinical MS -- and even more elevated after onset of clinical MS. “In certain patients with concerning imaging findings or with abnormal neurological examination findings, I may order serum biomarkers,” said Dr. Yu.

Meanwhile, ongoing research is expected to further advance the early detection of MS.