A new protein measured in the blood makes it possible to detect inflammatory flare-ups of multiple sclerosis in its relapsing form. To better deal with them.
According to a study published in the journal Neurology, the presence of a protein in the blood of patients suffering from a relapsing form of multiple sclerosis, the NF-L protein, could announce relapses and make it possible to better adjust the treatment to the level of activity of the disease.
85 patients followed for two years
A study published by the American Academy of Neurology shows how the presence of proteins, neurofilament light chain (NF-L) and chitinase-3 like protein 1 (CHI3L1), can help predict disease flares, in the framework of a relapsing form of multiple sclerosis.
Researchers followed 85 patients with relapsing-remitting multiple sclerosis for two years. During the first six months, these patients did not take any treatment. Then, for a year and a half, they were treated with interferon beta-1a, an effective immunomodulatory treatment in MS.
Blood samples were taken at baseline, then at the third, sixth, twelfth and twenty-fourth month. The researchers then studied the level of neurofilament light chain (NF-L) in the blood.
A high level of NF-L indicates a flare-up
According to the results of the study, patients who have a high level of NF-L in their blood have, in parallel, new cerebral lesions visible on MRI (T1-gado and T2), which is not the cases in patients whose rate remains low. The level of NF-L drops during treatment with interferon beta-1a and therefore reflects a new outbreak of multiple sclerosis and its treatment. At the same time, in this study the level of CHI3L1 is not correlated with the MRI lesions, nor with the treatment and does not really seem to reflect the inflammatory disease of the nervous system.
an inflammatory disease
There are two types of multiple sclerosis. The most common early in the disease is multiple sclerosis in its relapsing form. That is to say, it evolves by alternating phases of relapses and phases of remissions. Patients can live with this unique form of the disease.
But, from the outset in some patients, or secondarily for others, a progressive form appears. Patients suffering from progressive multiple sclerosis no longer have flare-ups. But a handicap sets in gradually. It can get worse slowly, or on the contrary very quickly.
Thus, monitoring the level of NF-L in the blood of patients could help prevent flare-ups of multiple sclerosis. The researchers see NF-L as a promising biomarker of disease activity, useful for adjusting treatment as closely as possible to the needs of the disease. NF-L could also become an alternative to MRI, one of the most expensive imaging techniques and access to which remains restricted in France.
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