Matute-Blanch Clara, Montalban Xavier, Comabella Manuel
Neurology and Neuroimmunology Service, Multiple Sclerosis Center of Catalunya and Institut de Recerca Vall d'Hebron, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Neurology and Neuroimmunology Service, Multiple Sclerosis Center of Catalunya and Institut de Recerca Vall d'Hebron, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
Handb Clin Neurol. 2017;146:67-84. doi: 10.1016/B978-0-12-804279-3.00005-8.
Multiple sclerosis (MS) is characterized by a substantial degree of heterogeneity in relation to clinical manifestations, disease course, radiologic findings, histopathologic characteristics of brain lesions, and response to treatment. In this scenario, there is a strong need in MS for biomarkers that reliably capture these diverse aspects of disease heterogeneity and assist, for instance, in disease diagnosis and stratification, in the prediction of disease course, or in the identification of new and effective therapies for the disease. Due to its close proximity to sites of inflammatory lesions, biomarkers measured in cerebrospinal fluid (CSF) are likely to be more informative compared to other body fluid sources such as peripheral blood or urine. This chapter will review the current knowledge existing on CSF molecular biomarkers in MS and also neuromyelitis optica, a pathologic condition originally considered to be a form of MS, following a classification of biomarkers based on the predominant pathophysiologic processes taking place in these two diseases: activation/inflammatory biomarkers; oxidative stress biomarkers; neuroaxonal damage biomarkers; and remyelination and demyelination biomarkers.
多发性硬化症（MS）在临床表现、病程、影像学表现、脑损伤的组织病理学特征以及对治疗的反应方面存在很大程度的异质性。在这种情况下，MS领域迫切需要能够可靠地反映疾病异质性这些不同方面的生物标志物，例如辅助疾病诊断和分层、预测疾病进程或识别针对该疾病的新的有效疗法。由于脑脊液（CSF）与炎症损伤部位距离较近，与外周血或尿液等其他体液来源相比，在CSF中检测到的生物标志物可能更具信息价值。本章将基于这两种疾病中主要发生的病理生理过程对生物标志物进行分类，回顾目前关于MS以及视神经脊髓炎（一种最初被认为是MS的病理状况）中CSF分子生物标志物的现有知识：激活/炎症生物标志物；氧化应激生物标志物；神经轴突损伤生物标志物；以及髓鞘再生和脱髓鞘生物标志物。
