Findings could pave way for more targeted treatments, researchers say
by Marisa Wexler, MS | August 11, 2023
An antibody biomarker may help to distinguish people with a disease that resembles multiple sclerosis (MS), but may actually be its own clinical disorder, according to a new study.
The biomarker was present in about 1% of MS patients and in 6% of those with a related demyelinating condition called neuromyelitis optica spectrum disorder (NMOSD).
“By distinguishing between myelin-destroying autoimmune diseases that were previously all called MS, we’re taking an important step towards a better understanding of the causes of these illnesses and towards individualized treatments,” Anne-Katrin Pröbstel, MD, a professor at the University of Basel and co-author of the study, said in a university news story.
The study, “Immunoglobulin A Antibodies Against Myelin Oligodendrocyte Glycoprotein in a Subgroup of Patients With Central Nervous System Demyelination,” was published in JAMA Neurology.
‘MS’ used to describe disease where inflammation causes CNS myelin damage
MS is characterized by inflammation in the central nervous system (CNS, comprising the brain and spinal cord) that causes damage to the myelin sheath, a fatty covering around nerve fibers that helps them send electrical signals. This inflammatory myelin damage disrupts nerve signaling, ultimately leading to disease symptoms.
For most of modern medical history, the term “multiple sclerosis” has been broadly used to describe any disease where inflammation causes myelin damage in the CNS. However, in recent years, researchers have begun to more specifically identify inflammatory CNS diseases that are better recognized as their own separate clinical entity.
As an example, NMOSD was long considered to be a subtype of MS but it is now considered a separate disease. NMOSD is defined by the presence of a specific type of antibody, called immunoglobulin G or IgG, which targets a brain protein called AQP4 to drive disease.
Identifying NMOSD as its own disease has helped clinicians to better understand the underlying disease processes, which in turn has paved the way for more targeted treatment approaches.
Another IgG antibody targeting the protein MOG (myelin oligodendrocyte glycoprotein) has also been found to be a marker of a distinct clinical entity, called MOG antibody disease or MOGAD, which was previously considered a subtype of MS or NMOSD.
Scientists study immunoglobulin A antibody
In this study, scientists turned their attention to another type of antibody called immunoglobulin A or IgA. Whereas IgG antibodies are produced throughout the body, IgA are mainly made in mucus membranes.
“In contrast to IgG, which is known for its proinflammatory role … the pathogenic [disease-causing] potential of IgA is debated,” the researchers wrote.
The scientists conducted an analysis of data from 1,339 people with inflammatory demyelinating CNS diseases. Most of these individuals had been diagnosed with MS, and some with NMOSD or MOGAD.
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