Department of neurology, centre hospitalier universitaire Carémeau, 9, place du Pr. Robert Debré, 30029 Nîmes cedex 9, France; Équipe neuroprotéomique et signalisation des maladies neurologiques et psychiatriques, UMR5203, institut de génomique fonctionnelle, université de Montpellier, 141, rue de la Cardonille, 34094 Montpellier c edex 5, France.
Rev Neurol (Paris). 2018 Jun;174(6):364-371. doi: 10.1016/j.neurol.2018.04.002. Epub 2018 May 19.
Multiple sclerosis (MS) is a complex heterogeneous disease. Diagnostic criteria are based on symptoms, biomarkers, MRI data and exclusion of differential diagnoses. Over the past few years, the usefulness of biomarkers has progressively decreased with the development of new MRI criteria, yet dozens of new biomarkers, especially in cerebrospinal fluid, for MS diagnosis and prognosis have been described. Large-scale studies validating some of these new biomarkers have also provided confirmation of a restricted set of biomarkers (presented here in this review) as having potential value for different stages of the disease, including as early as clinically isolated syndrome and radiologically isolated syndrome. However, differentiating progressive forms of MS from relapsing-remitting MS remains a genuine challenge, and could help to predict future conversion to secondary-progressive MS. In addition, new approaches combining multiple biomarkers might allow us to unravel the complexity of the disease and determine disease stages more precisely. Moreover, recent technological developments allowing analysis of biomarkers in plasma have also provided less invasive analysis of MS, and should serve to predict MS evolution and therapeutic responses during follow-up.
多发性硬化症 (MS) 是一种复杂的异质性疾病。诊断标准基于症状、生物标志物、MRI 数据和排除鉴别诊断。在过去的几年中，随着新的 MRI 标准的发展，生物标志物的有用性逐渐降低，但已经描述了数十种用于 MS 诊断和预后的新的生物标志物，特别是在脑脊液中。一些新的生物标志物的大规模研究也证实了一组有限的生物标志物（在本综述中介绍）在疾病的不同阶段具有潜在价值，包括在临床孤立综合征和放射学孤立综合征中。然而，区分 MS 的进行性形式和复发性缓解型 MS 仍然是一个真正的挑战，并有助于预测未来向继发性进行性 MS 的转化。此外，结合多个生物标志物的新方法可能使我们能够揭示疾病的复杂性，并更准确地确定疾病阶段。此外，允许在血浆中分析生物标志物的最新技术发展也为 MS 的非侵入性分析提供了可能，并应有助于在随访期间预测 MS 的演变和治疗反应。
