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Maglio G, D’Agostino M, Caronte FP, Pezone L, Casamassimi A, Rienzo M, Di Zazzo E, Nappo C, Medici N, Molinari AM, Abbondanza C. Multiple Sclerosis: From the Application of Oligoclonal Bands to Novel Potential Biomarkers. Int J Mol Sci 2024; 25:5412. [PMID: 38791450 PMCID: PMC11121866 DOI: 10.3390/ijms25105412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
Multiple sclerosis is a chronic immune-mediated disorder of the central nervous system with a high heterogeneity among patients. In the clinical setting, one of the main challenges is a proper and early diagnosis for the prediction of disease activity. Current diagnosis is based on the integration of clinical, imaging, and laboratory results, with the latter based on the presence of intrathecal IgG oligoclonal bands in the cerebrospinal fluid whose detection via isoelectric focusing followed by immunoblotting represents the gold standard. Intrathecal synthesis can also be evidenced by the measurement of kappa free light chains in the cerebrospinal fluid, which has reached similar diagnostic accuracy compared to that of oligoclonal bands in the identification of patients with multiple sclerosis; moreover, recent studies have also highlighted its value for early disease activity prediction. This strategy has significant advantages as compared to using oligoclonal band detection, even though some issues remain open. Here, we discuss the current methods applied for cerebrospinal fluid analysis to achieve the most accurate diagnosis and for follow-up and prognosis evaluation. In addition, we describe new promising biomarkers, currently under investigation, that could contribute both to a better diagnosis of multiple sclerosis and to its monitoring of the therapeutic treatment response.
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Affiliation(s)
- Grazia Maglio
- Unit of Clinical and Molecular Pathology, A.O.U. University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.M.); (M.D.); (F.P.C.); (L.P.); (C.N.); (N.M.); (A.M.M.)
| | - Marina D’Agostino
- Unit of Clinical and Molecular Pathology, A.O.U. University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.M.); (M.D.); (F.P.C.); (L.P.); (C.N.); (N.M.); (A.M.M.)
| | - Francesco Pio Caronte
- Unit of Clinical and Molecular Pathology, A.O.U. University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.M.); (M.D.); (F.P.C.); (L.P.); (C.N.); (N.M.); (A.M.M.)
| | - Luciano Pezone
- Unit of Clinical and Molecular Pathology, A.O.U. University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.M.); (M.D.); (F.P.C.); (L.P.); (C.N.); (N.M.); (A.M.M.)
| | - Amelia Casamassimi
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Monica Rienzo
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy;
| | - Erika Di Zazzo
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy;
| | - Carmela Nappo
- Unit of Clinical and Molecular Pathology, A.O.U. University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.M.); (M.D.); (F.P.C.); (L.P.); (C.N.); (N.M.); (A.M.M.)
| | - Nicola Medici
- Unit of Clinical and Molecular Pathology, A.O.U. University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.M.); (M.D.); (F.P.C.); (L.P.); (C.N.); (N.M.); (A.M.M.)
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Anna Maria Molinari
- Unit of Clinical and Molecular Pathology, A.O.U. University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.M.); (M.D.); (F.P.C.); (L.P.); (C.N.); (N.M.); (A.M.M.)
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Ciro Abbondanza
- Unit of Clinical and Molecular Pathology, A.O.U. University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.M.); (M.D.); (F.P.C.); (L.P.); (C.N.); (N.M.); (A.M.M.)
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
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Tryfonos C, Chrysafi M, Vadikolias K, Berberoglou L, Vorvolakos T, Dimoliani S, Tsourouflis G, Kontogiorgis C, Antasouras G, Giaginis C. Nutritional interventional studies in patients with multiple sclerosis: a scoping review of the current clinical evidence. J Neurol 2024; 271:1536-1570. [PMID: 38177875 DOI: 10.1007/s00415-023-12140-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 10/15/2023] [Accepted: 11/25/2023] [Indexed: 01/06/2024]
Abstract
A good nutritional status appears to slow down disease progression and ameliorate symptoms' intensity in patients with multiple sclerosis (MS). Up to date, there are several interventional studies, which have explored the potential beneficial effects of specific dietary patterns as well as specific bioactive nutrients against disease progression and symptomatology of MS patients. This is a thorough, scoping review, which aims to critically summarize and scrutinize the currently available clinical evidence of the potential beneficial effects of nutritional interventional studies against MS progression and symptomatology. This review was conducted to systematically map the research done in this area, as well as to identify gaps in knowledge. For this purpose, we thoroughly explored the most accurate scientific web databases, e.g., PubMed, Scopus, Web of Science, and Google Scholar to achieve the most relevant clinical human studies applying effective and characteristic keywords. There are currently several dietary patterns and specific bioactive nutrients that show promising results by slowing down disease progression and by improving MS symptoms. However, there are also certain conflicting results, while most of the existing studies enrolled a small number of MS patients. Nutritional interventions may exert substantial protective effects against MS progression and symptomatology. However, large, long-term, randomized, double-blind, controlled clinical trials with a prospective design are strongly recommended to delineate whether such nutritional intervention may attenuate disease progression, and improve symptomatology in MS patients.
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Affiliation(s)
- Christina Tryfonos
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400, Myrina, Greece
| | - Maria Chrysafi
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400, Myrina, Greece
| | - Konstantinos Vadikolias
- Department of Neurology, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Lefteris Berberoglou
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Campus (Dragana) Building 5, 68100, Alexandroupolis, Greece
| | - Theofanis Vorvolakos
- Department of Psychiatry, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Sophia Dimoliani
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400, Myrina, Greece
| | - Gerasimos Tsourouflis
- Second Department of Surgery, Propedeutic, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Christos Kontogiorgis
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, Campus (Dragana) Building 5, 68100, Alexandroupolis, Greece
| | - Georgios Antasouras
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400, Myrina, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400, Myrina, Greece.
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Oppong AE, Coelewij L, Robertson G, Martin-Gutierrez L, Waddington KE, Dönnes P, Nytrova P, Farrell R, Pineda-Torra I, Jury EC. Blood metabolomic and transcriptomic signatures stratify patient subgroups in multiple sclerosis according to disease severity. iScience 2024; 27:109225. [PMID: 38433900 PMCID: PMC10907838 DOI: 10.1016/j.isci.2024.109225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/20/2023] [Accepted: 02/08/2024] [Indexed: 03/05/2024] Open
Abstract
There are no blood-based biomarkers distinguishing patients with relapsing-remitting (RRMS) from secondary progressive multiple sclerosis (SPMS) although evidence supports metabolomic changes according to MS disease severity. Here machine learning analysis of serum metabolomic data stratified patients with RRMS from SPMS with high accuracy and a putative score was developed that stratified MS patient subsets. The top differentially expressed metabolites between SPMS versus patients with RRMS included lipids and fatty acids, metabolites enriched in pathways related to cellular respiration, notably, elevated lactate and glutamine (gluconeogenesis-related) and acetoacetate and bOHbutyrate (ketone bodies), and reduced alanine and pyruvate (glycolysis-related). Serum metabolomic changes were recapitulated in the whole blood transcriptome, whereby differentially expressed genes were also enriched in cellular respiration pathways in patients with SPMS. The final gene-metabolite interaction network demonstrated a potential metabolic shift from glycolysis toward increased gluconeogenesis and ketogenesis in SPMS, indicating metabolic stress which may trigger stress response pathways and subsequent neurodegeneration.
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Affiliation(s)
- Alexandra E. Oppong
- Division of Medicine, Department of Inflammation, University College London, London WC1E 6JF, UK
| | - Leda Coelewij
- Division of Medicine, Department of Inflammation, University College London, London WC1E 6JF, UK
| | - Georgia Robertson
- Division of Medicine, Department of Inflammation, University College London, London WC1E 6JF, UK
| | - Lucia Martin-Gutierrez
- Division of Medicine, Department of Inflammation, University College London, London WC1E 6JF, UK
| | - Kirsty E. Waddington
- Division of Medicine, Department of Inflammation, University College London, London WC1E 6JF, UK
| | - Pierre Dönnes
- Division of Medicine, Department of Inflammation, University College London, London WC1E 6JF, UK
- Scicross AB, Skövde, Sweden
| | - Petra Nytrova
- Department of Neurology and Centre of Clinical, Neuroscience, First Faculty of Medicine, General University Hospital and First Faculty of Medicine, Charles University in Prague, 500 03 Prague, Czech Republic
| | - Rachel Farrell
- Department of Neuroinflammation, University College London and Institute of Neurology and National Hospital of Neurology and Neurosurgery, London WC1N 3BG, UK
| | - Inés Pineda-Torra
- Division of Medicine, Department of Inflammation, University College London, London WC1E 6JF, UK
| | - Elizabeth C. Jury
- Division of Medicine, Department of Inflammation, University College London, London WC1E 6JF, UK
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