Blood Test Predicts Multiple Sclerosis Years Before Symptoms Appear

Researchers at the University of California, San Francisco, (UCSF) have identified a specific pattern of autoantibodies in the blood that precedes the clinical onset of multiple sclerosis (MS). The study found that 10 percent of MS patients displayed a unique set of autoantibodies against both human proteins and common pathogens like the Epstein-Barr virus (EBV) years before showing symptoms. These findings could lead to a simple blood test for early detection of MS, allowing for timely intervention with more effective therapies. 

In about one in 10 cases of MS, the body begins producing a distinctive set of antibodies against its own proteins years before symptoms emerge. These autoantibodies appear to bind to both human cells and common pathogens, possibly explaining the immune attacks on the brain and spinal cord that are the hallmark of MS. 

The finding was a result of a search for autoantibodies in the blood of people with MS. Samples were obtained from the U.S. Department of Defense Serum Repository, which stores blood taken from armed service members when they apply to join the military, from 250 MS patients collected after their diagnosis, plus samples taken five or more years earlier when they joined the military. The researchers also looked at comparable blood samples from 250 healthy veterans. Using a mere one-thousandth of a milliliter of blood from each time point, the scientists thought they would see a jump in autoantibodies as the first symptoms of MS appeared. Instead, they found that 10 percent of the MS patients had a striking abundance of autoantibodies years before their diagnosis. 

The dozen or so autoantibodies all stuck to a chemical pattern that resembled one found in common viruses, including EBV, which infects more than 85 percent of all people, yet has been flagged in previous studies as a contributing cause for MS. Years before diagnosis, this subset of MS patients had other signs of an immune war in the brain. Ahmed Abdelhak, MD, co-author of the paper and a postdoctoral researcher in the UCSF laboratory of Ari Green, MD, found that patients with these autoantibodies had elevated levels of neurofilament light, a protein that gets released as neurons break down. 

To confirm their findings, the team analyzed blood samples from patients in the UCSF ORIGINS study. These patients all had neurological symptoms and many, but not all, went on to be diagnosed with MS. Once again, 10 percent of the patients in the ORIGINS study who were diagnosed with MS had the same autoantibody pattern. The pattern was 100 percent predictive of an MS diagnosis. Across both the Department of Defense and ORIGINS groups, every patient with this autoantibody pattern had MS.