It is also known as the “disease with a thousand faces”, precisely because this immune disease can have a very different course from person to person. The symptoms of multiple sclerosis (MS) can also vary greatly from person to person, depending on which areas of the central nervous system are affected. All these are the reason why it is so difficult to effectively fight this terrible disease. Long before the first symptoms appear, so-called biomarkers can predict that there is some nerve damage that is characteristic of multiple sclerosis. And because this disease progresses differently, it needs some more warning messages, or indications, as early as possible.

The cause is unclear

Researchers at the University of California and the Swiss Multiple Sclerosis Federation (SMSC), one of the largest databases for clinical studies of the disease, have now discovered a new biomarker that could lead to starting treatment two years earlier and with more targeted way. According to a study published in the specialized journal “Jama Neurology”, the researchers found a sharp increase in the so-called NfL protein in the blood serum, 12 to 26 months before the first symptoms appeared. Neurofilament chain (NfL) is the same protein found in nerve cells and is responsible for stability and circulation within the cell. About 2.8 million people worldwide have MS. The causes of the disease are still poorly understood. There may be a connection with the Epstein-Barr virus, known mainly as the cause of infectious mononucleosis, the so-called “kissing disease”. However, it has not been proven whether MS actually occurs after infection with this virus. It could also be linked to environmental factors.

Reduced exposure to sunlight and lower levels of vitamin D could also play a role. This in turn could explain why multiple sclerosis is more common in northern latitudes, such as Scandinavia, northern Europe and Canada, than in southern countries. Unfortunately in our time there is still no cure. Treatment so far focuses on slowing the progression of the disease, minimizing the relapses that typically characterize the disease, and relieving symptoms.

A more timely and more personalized treatment possible

It still remains unclear why in MS the immune system mistakenly attacks the central nervous system, especially the protective myelin layer that surrounds nerve cells. Inflamed nerve fibers cause muscle weakness and numbness in the extremities, especially in the legs, or disorders of so-called fine motor skills, which can lead to difficulties in grasping and writing, for example. Many people with MS also suffer from visual disturbances, fatigue, dizziness and psychological problems. The type and severity of symptoms depend on which areas of the brain and spinal cord are affected. Only recently have researchers discovered two biomarkers, the so-called free light chains (κ-FLC, kappa free light chains) and serum neurofilament light (sNfL) for the prognosis of the early stage in the progression of the disease. With the recently recognized biomarker, science has another, third important indicator, a “harbinger” of the disease.

“Our results represent an important milestone in the understanding of MS,” explains study leader Ahmed Abdelhak from the University of California, Berkeley. “This opens a new window of opportunity for early therapeutic intervention and changes the way we look at monitoring and treating the disease,” says the researcher. Because the symptoms of MS vary so much from person to person, NfL levels in humans they can provide important information about disease activity. “The results highlight the pioneering value of NfL as a biomarker for personalized medical treatment,” emphasizes Abdelhak, giving some new hope to those struggling to deal with it.