Cerebrospinal fluid GAP-43 in early multiple sclerosis

Area of Science:

• Neuroscience
• Biomarker Discovery
• Inflammation Research

Background:

• Multiple sclerosis (MS) diagnosis and monitoring require novel biomarkers for disease activity.
• Axonal loss, a hallmark of MS, correlates with patient disability.
• Growth-associated protein 43 (GAP-43) is involved in axonal growth and regeneration.

Purpose of the Study:

• To investigate Growth-associated protein 43 (GAP-43) as a potential biomarker for axonal regeneration capacity in multiple sclerosis (MS).
• To assess GAP-43 levels in cerebrospinal fluid (CSF) of individuals with clinically isolated syndrome, MS, and controls.

Main Methods:

• Development of a novel enzyme-linked immunosorbent assay (ELISA) for quantifying GAP-43 in CSF.
• Measurement of CSF GAP-43 levels in 71 patients with clinically isolated syndrome, 139 MS patients, and 51 controls.

Main Results:

• CSF GAP-43 concentrations were similar between MS patients and controls.
• Higher GAP-43 levels were observed in MS patients with >10 T2-magnetic resonance imaging (MRI) lesions.
• CSF GAP-43 correlated with CSF mononuclear cell counts and inversely with patient age, with trends towards higher levels in those with gadolinium-enhancing lesions and positive oligoclonal IgG.

Conclusions:

• Axonal regeneration capacity appears preserved in early stages of MS.
• CSF GAP-43 concentration is associated with inflammatory markers in early MS.
• Findings suggest potential inflammatory-driven expression of GAP-43 in early MS, highlighting its role in disease activity.