IgM to phosphatidylcholine in multiple sclerosis patients: from the diagnosis to the treatment

Multiple sclerosis (MS) is a demyelinating and neurodegenerative disease of the central nervous system. It affects young people, and a considerable percentage of patients need the help of a wheelchair in 15 years of evolution. Currently, there is not a specific technique for the diagnosis of MS. The detection of oligoclonal IgG bands (OIgGBs) is the most sensitive assay for it, but it is not standardizable, only reference laboratories develop it, and uses cerebrospinal fluid. To obtain this sample, a lumbar puncture is necessary, an invasive proceeding with important side effects. It is important to develop and implement standard assays to obtain a rapid diagnosis because the earlier the treatment, the better the evolution of the disease. There are numerous modifying disease therapies, which delay the progression of the disease, but they have important side effects, and a considerable percentage of patients give up the treatment. In addition, around 40% of MS patients do not respond to the therapy and the disease progresses. Numerous researches have been focused on the characterization of predictive biomarkers of response to treatment, in order to help physicians to decide when to change to a second-line treatment, and then the best therapeutic option. Here, we review the new biomarkers for the diagnosis and response to treatment in MS. We draw attention in a new assay, the detection of serum IgM to phosphatidylcholine, that showed a similar sensitivity as OIgGBs and predicts the response to disease modifying treatments.

Automated summary

Multiple sclerosis (MS) is a debilitating disease that affects the central nervous system, often leading to the need for wheelchair assistance within 15 years of onset. Currently, there is no standardized technique for diagnosing MS, with the detection of oligoclonal IgG bands (OIgGBs) being the most sensitive assay, but limited to reference laboratories and requiring cerebrospinal fluid. Early diagnosis is crucial for better disease management, but existing disease modifying therapies come with significant side effects and a considerable percentage of patients discontinuing treatment. Research has focused on identifying predictive biomarkers for treatment response, and a new assay involving the detection of serum IgM to phosphatidylcholine has shown promise in predicting treatment response.