Neurodegenerative Biomarkers in Multiple Sclerosis: At the Interface Between Research and Clinical Practice.

Area of Science:

• Neuroscience
• Immunology
• Biomarker Discovery

Background:

• Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system (CNS).
• Neurodegeneration, a key driver of MS-related disability, requires further investigation beyond inflammation.
• Validated biomarkers are crucial for MS diagnosis, prognosis, and monitoring therapeutic responses.

Purpose of the Study:

• To review current cerebrospinal fluid (CSF) and blood-based biomarkers for neurodegeneration in MS.
• To explore specific molecular indicators including neurofilaments, lipids, and kynurenines.
• To emphasize the importance of these biomarkers for clinical applications in MS management.

Main Methods:

• Literature review of studies focusing on neurodegenerative markers in MS.
• Analysis of various biomarker classes: neurofilaments, lipid profiles, kynurenine pathway metabolites.
• Synthesis of data on biomarker relevance for diagnosis, prognosis, and treatment evaluation.

Main Results:

• Neurofilaments (e.g., NfL) are sensitive indicators of axonal damage and neurodegeneration in MS.
• Altered lipid metabolism and kynurenine pathway metabolites reflect underlying neurodegenerative processes.
• Multiple CSF and blood biomarkers offer complementary insights into MS neurodegeneration.

Conclusions:

• Cerebrospinal fluid and blood biomarkers are vital for assessing neurodegeneration in multiple sclerosis.
• These molecular indicators hold significant potential for improving clinical management and patient outcomes.
• Further validation is needed to integrate these biomarkers into routine MS care.