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An Update on Laboratory-Based Diagnostic Biomarkers for Multiple Sclerosis and Beyond
Ruba S Saadeh1, Paola A Ramos1, Alicia Algeciras-Schimnich1
1Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
Clinical Chemistry
|August 8, 2022
Summary
New biomarkers improve the diagnosis of multiple sclerosis (MS) and related CNS demyelinating disorders. Updated laboratory testing aids in differentiating MS from mimics, enhancing diagnostic accuracy.
Area of Science:
- Neurology
- Immunology
- Clinical Diagnostics
Background:
- Multiple sclerosis (MS) is an immune-mediated CNS inflammatory demyelinating disease.
- Diagnosis relies on clinical presentation, imaging, and laboratory tests.
- Traditional tests include CSF IgG index and oligoclonal bands.
Purpose of the Study:
- Review laboratory tests for MS diagnosis and differentiation from mimics.
- Discuss the utility and selection of novel biomarkers.
- Highlight emerging biomarkers and future perspectives in laboratory testing.
Main Methods:
- Review of established and emerging biomarkers for CNS demyelinating disorders.
- Analysis of cerebrospinal fluid (CSF) and serum testing methodologies.
- Evaluation of diagnostic utility and workflow improvements.
Main Results:
- Novel biomarkers like AQP4 and MOG antibodies aid in diagnosing MS mimics.
- Emerging biomarkers, such as CSF kappa free light chains, offer potential workflow improvements.
- Biomarkers of disease activity and prognosis include NfL, GFAP, and MBP.
Conclusions:
- Updated laboratory testing, including novel biomarkers, reduces MS misdiagnosis.
- CSF/serum biomarkers are crucial for MS diagnostic criteria and differentiation.
- Advancements in biomarker discovery and testing tools are vital for future diagnostics.
