WASHINGTON – Johns Hopkins University researchers have identified a protein that may be the key to developing the first test for multiple sclerosis, and it could eventually help improve treatment for the debilitating disease.
The protein, found only in spinal fluid, might pinpoint patients who have MS and those at risk of developing the disease, said Avindra Nath, lead author of the study. The protein could also lead to new treatment approaches, according to the findings, which were published in the February issue of the journal Annals of Neurology.
“We’ve identified a protein that tells us something is happening in patients,” said Nath, a professor in the Department of Neurology in the university’s School of Medicine. “It might be useful not only for diagnosing the disease, but also finding methods of treatment.”
The protein, called 12.5 kDa cystatin, was found in two-thirds of patients with MS or pre-MS conditions in the study, Nath said. The protein breaks down from a larger protein linked to the destruction of the area of nerve cells that sends signals.
“(This discovery) opens up the hopes that we may be able to diagnose the disease and may be able to monitor the disease, and it may open up new therapeutic approaches for us to look at,” he said.
About 400,000 people in the United States — most of whom are women — suffer from MS, according to the National Multiple Sclerosis Society, which helped fund the study. The disorder is associated with the destruction of nerve cells by the immune system. Symptoms often include fatigue, depression, dizziness and problems with vision and speech.
Patricia O’Looney, director of biomedical research programs for the society, said the researchers are seeking a reliable way to measure disease activity.
“This group is trying to find some component that correlates to the disease itself,” O’Looney said. “Especially considering recent developments in looking at proteins, this research is important.”
MS cannot be diagnosed by a simple blood test or similar analysis, distinguishing it from most other diseases in which the body attacks its own cells. Typically, MS is diagnosed only after symptoms are exhibited and through a combination of tests.
Last November, a University of Ottawa professor successfully used a blood test to predict the severity of the disease in some patients after their first attack.
Nath chose spinal fluid over blood because spinal fluid gives a better picture of what’s occurring in the brain, he said.
A main concern Nath had regarding his study was its small sample size of 30 patients, he said. Still, he called the results a “reliable indicator” of what is happening in most MS patients.
O’Looney said the study was too small to yield large-scale results.
“It’s a good first step, but certainly more patients need to be looked at,” she said.
All patients in the study were diagnosed with “remitting-relapsing” MS, Nath said. About 85 percent of people with MS suffer from the remitting-relapsing type, making it the most common form of the disease, according to the National Multiple Sclerosis Society. People with remitting-relapsing MS experience episodes of symptoms marked by periods of partial or complete remission.
This study was the first foray into an unexplored area of research, Nath said. He wants to know whether the protein is found in other types of MS and exactly how the protein forms. He also said he would like to expand future studies to as many as 100 people.
Nath was reluctant to declare that he had found a possible test for MS, but he was optimistic about the protein’s role in future diagnosis and treatment.
“I’m not ready to say that yet,” he said. “That’s what we’d like to know. But this is a step in the right direction.”
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