title: Body fluid biomarkers for multiple sclerosis--the long road to clinical application.
abstract: There is a strong unmet clinical need for objective body fluid biomarkers to assist early diagnosis and estimate long-term prognosis, monitor treatment response and predict potential adverse effects in multiple sclerosis (MS). Here, we review recent studies (focusing on 2012 to early 2015) on body fluid markers in MS from the perspective of their clinical utility. Because the first step towards clinical implementation of a newly discovered biomarker is independent replication, we focus on biomarkers that have been validated in at least two independent cohorts. We also discuss recent data challenging earlier findings, and biomarkers for which new clinical uses are suggested. For early MS diagnosis and prediction of conversion from clinically isolated syndrome to MS, several new B-cell-associated candidate blood biomarkers have emerged. For prognosis, several novel axonal damage markers should be adopted to biomarker panels. The number of disease-modifying treatments for MS has increased sharply, but biomarkers for treatment response monitoring and adverse effect prediction are scarce, and markers for subtyping and staging of MS are still lacking. In view of the availability and implementation of several standardized protocols to optimize biomarker studies, we expect biomarker development for MS to be improved and accelerated, with clinical implementation in the near future.
authors.affiliation: Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands.
authors.forename: Charlotte E
authors.initials: CE
authors.lastname: Teunissen
authors.affiliation: Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands.
authors.forename: Arjan
authors.initials: A
authors.lastname: Malekzadeh
authors.affiliation: Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands.
authors.forename: Cyra
authors.initials: C
authors.lastname: Leurs
authors.affiliation: Department of Clinical Neurosciences, Division of Neurology, Unit of Neuroimmunology and Multiple Sclerosis, Geneva University Hospital, Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland.
authors.forename: Claire
authors.initials: C
authors.lastname: Bridel
authors.affiliation: Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands.
authors.forename: Joep
authors.initials: J
authors.lastname: Killestein
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D001826:Body Fluids / Q000378:metabolism; D018450:Disease Progression; D042241:Early Diagnosis; D006801:Humans; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000378:metabolism* / Q000628:therapy; D011379:Prognosis
chemical_list: D015415:Biomarkers