How Do Doctors Test MS
Blood test instead of tomography - detect flare-ups in multiple sclerosis early in the blood count
In order to alleviate the symptoms of the patient and to positively influence the course of the disease, however, the acute flare-ups can be treated. "That is why it is important to recognize an MS attack at an early stage - preferably before the first symptoms appear," emphasizes Prof. Dr. Torsten Witte from the Hannover Medical School. Recognizing an MS flare-up is not easy: Less than a quarter of the flare-ups are actually diagnosed and then treated. So far, doctors have only been able to reliably identify an MS attack by displaying the characteristic inflammation foci in the magnetic resonance tomograph. In the future, the diagnosis should be made faster, easier and cheaper: by means of a blood test.
Antibody signals a disease flare-up
But what substance in the blood of MS patients indicates a flare-up? "We have found that patients who come to the clinic with an MS attack have an increased level of autoantibodies against a protein called alpha-fodrin in their blood," says Professor Witte. An autoantibody is an antibody that is not directed against external intruders, but against your own body. With this antibody, a biomarker was found for the first time, which is directly connected to the relapses of multiple sclerosis. Together with colleagues, Professor Witte is now developing a laboratory test for the detection of alpha-fodrin in the blood and thus for the diagnosis of MS attacks. The project is funded by the Federal Ministry of Education and Research (BMBF) as part of the “Molecular Diagnostics” funding measure.
The immune system plays an important role in the development of MS. “Normally, our immune system fights external intruders, such as viruses or bacteria. In multiple sclerosis, however, the immune system is directed against its own body. That is why multiple sclerosis is also counted among the autoimmune diseases, ”describes Professor Witte. The immune system then forms antibodies against the body's own tissue, such as against alpha-fodrin. This protein is found in large quantities in the protective sheaths of nerve cells, the so-called marrow or myelin sheaths. If they are “attacked” by antibodies, inflammation develops: nerve impulses from the brain and spinal cord can then no longer be properly passed on to different regions of the body. A variety of neurological symptoms are the result, such as visual disturbances, tingling in the skin, nerve pain or paralysis. The myelin sheaths in the brain, optic nerve or spinal cord of MS patients can be permanently destroyed by this inflammation.
Test works before symptoms develop
In order to produce a working test, the scientists first had to find out which part of the alpha-fodrin protein the autoantibodies in MS patients are actually directed against. “There are three areas in alpha-fodrin that are only recognized by the autoantibodies in the blood of MS patients during a disease flare-up. After an MS attack, these specific autoantibodies disappeared from the blood, ”explains Professor Witte. Currently, the researchers can reliably detect an MS flare-up in 80 percent of the cases with their alpha-fodrin blood test. "Even in the blood of supposedly symptom-free patients, we sometimes found elevated levels of autoantibodies." The magnetic resonance tomograph actually showed an unnoticed progression of the disease in these patients. “Our simple blood test can therefore indicate an MS attack before the first symptoms appear,” says Professor Witte.
Prof. Dr. Torsten Witte
Hannover Medical School
Clinic for Immunology and Rheumatology
Tel .: 0511 532-3014
Fax: 0511 532-8055
Email: [email protected]
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