Vermersch Patrick, Berger Thomas, Gold Ralf, Lukas Carsten, Rovira Alex, Meesen Bianca, Chard Declan, Comabella Manuel, Palace Jacqueline, Trojano Maria
University of Lille, CHRU de Lille, Lille International Research Inflammation Center (LIRIC), INSRRM U995, FHU Imminent, Lille, France
Neuroimmunology and Multiple Sclerosis Clinic, Medical University of Innsbruck (MUI), Innsbruck, Austria.
Mult Scler. 2016 Aug;22(2 Suppl):18-33. doi: 10.1177/1352458516650739.
Multiple sclerosis (MS) is a highly heterogeneous disease, both in its course and in its response to treatments. Effective biomarkers may help predict disability progression and monitor patients' treatment responses.
The aim of this review was to focus on how biomarkers may contribute to treatment individualisation in MS patients.
This review reflects the content of presentations, polling results and discussions on the clinical perspective of MS during the first and second Pan-European MS Multi-stakeholder Colloquia in Brussels in May 2014 and 2015.
In clinical practice, magnetic resonance imaging (MRI) measures play a significant role in the diagnosis and follow-up of MS patients. Together with clinical markers, the rate of MRI-visible lesion accrual once a patient has started treatment may also help to predict subsequent treatment responsiveness. In addition, several molecular (immunological, genetic) biomarkers have been established that may play a role in predictive models of MS relapses and progression. To reach personalised treatment decisions, estimates of disability progression and likely treatment response should be carefully considered alongside the risk of serious adverse events, together with the patient's treatment expectations.
Although biomarkers may be very useful for individualised decision making in MS, many are still research tools and need to be validated before implementation in clinical practice.
多发性硬化症（MS）在病程和对治疗的反应方面都是一种高度异质性疾病。有效的生物标志物可能有助于预测残疾进展并监测患者的治疗反应。
本综述的目的是聚焦于生物标志物如何有助于MS患者的个体化治疗。
本综述反映了2014年5月和2015年5月在布鲁塞尔举行的第一届和第二届泛欧洲MS多利益相关方研讨会上关于MS临床视角的报告内容、投票结果和讨论。
在临床实践中，磁共振成像（MRI）测量在MS患者的诊断和随访中发挥着重要作用。与临床标志物一起，患者开始治疗后MRI可见病灶累积率也可能有助于预测后续治疗反应性。此外，已经确定了几种分子（免疫、遗传）生物标志物，它们可能在MS复发和进展的预测模型中发挥作用。为了做出个性化的治疗决策，在考虑严重不良事件风险以及患者的治疗期望的同时，应仔细考虑残疾进展估计和可能的治疗反应。
尽管生物标志物可能对MS的个体化决策非常有用，但许多仍然是研究工具，在临床实践中实施之前需要进行验证。
