多发性硬化症中的新兴影像和液体生物标志物。
Emerging imaging and liquid biomarkers in multiple sclerosis.
机构信息
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
出版信息
Eur J Immunol. 2023 Aug;53(8):e2250228. doi: 10.1002/eji.202250228. Epub 2023 May 28.
The advent of highly effective disease modifying therapy has transformed the landscape of multiple sclerosis (MS) care over the last two decades. However, there remains a critical, unmet need for sensitive and specific biomarkers to aid in diagnosis, prognosis, treatment monitoring, and the development of new interventions, particularly for people with progressive disease. This review evaluates the current data for several emerging imaging and liquid biomarkers in people with MS. MRI findings such as the central vein sign and paramagnetic rim lesions may improve MS diagnostic accuracy and evaluation of therapy efficacy in progressive disease. Serum and cerebrospinal fluid levels of several neuroglial proteins, such as neurofilament light chain and glial fibrillary acidic protein, show potential to be sensitive biomarkers of pathologic processes such as neuro-axonal injury or glial-inflammation. Additional promising biomarkers, including optical coherence tomography, cytokines and chemokines, microRNAs, and extracellular vesicles/exosomes, are also reviewed, among others. Beyond their potential integration into MS clinical care and interventional trials, several of these biomarkers may be informative of MS pathogenesis and help elucidate novel targets for treatment strategies.
在过去的二十年中,高效的疾病修正治疗的出现改变了多发性硬化症(MS)治疗的格局。然而,仍然存在着对敏感和特异性生物标志物的迫切需求,以帮助诊断、预后、治疗监测和新干预措施的开发,特别是对于进展性疾病患者。这篇综述评估了几种新兴的多发性硬化症影像和液体生物标志物的现有数据。MRI 发现,如中央静脉征和顺磁性边缘病变,可能提高 MS 的诊断准确性,并评估进展性疾病中的治疗效果。几种神经胶质蛋白(如神经丝轻链和神经胶质酸性蛋白)的血清和脑脊液水平显示出作为神经轴突损伤或神经胶质炎症等病理过程的敏感生物标志物的潜力。还综述了其他有前途的生物标志物,包括光相干断层扫描、细胞因子和趋化因子、microRNAs 和细胞外囊泡/外泌体等。除了它们在多发性硬化症临床护理和干预试验中的潜在整合外,其中一些生物标志物可能有助于阐明多发性硬化症的发病机制,并有助于确定治疗策略的新靶点。
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