BOSTON, MA—There are approximately 400,000 people in the United States with multiple sclerosis. Worldwide, the number jumps to more than 2.1 million people. Rather than a one-size-fits-all approach to treating the millions with multiple sclerosis, what if doctors could categorize patients to create more personalized treatments? A new study by researchers at Brigham and Women's Hospital (BWH) may one day make this idea a reality in the fight against the debilitating autoimmune disease.
A research team led by Philip De Jager, MD, PhD, BWH Department of Neurology, senior study author, has found a way to distinguish patients with multiple sclerosis into two meaningful subsets. The ability to categorize patients with multiple sclerosis may open new doors for treatment development.
The study will be electronically published on September 26, 2012 in Science Translational Medicine.
"Our results suggest that we can divide the multiple sclerosis patient population into groups that have different levels of disease activity," said De Jager. "These results motivate us to improve these distinctions with further research so that we may reach our goal of identifying the best treatment for each individual who has multiple sclerosis."
De Jager and his team extracted RNA—key molecules involved in making proteins from the instructions found in the DNA sequence—from blood cells of patients with multiple sclerosis. After analyzing the samples, they found distinct sets of RNA molecules among the patient samples. These unique sets formed a transcriptional signature that distinguished two sets of multiple sclerosis patients—MSa patients and MSb patients—with those in the MSa group having a higher risk for future multiple sclerosis relapse.
According to the researchers, knowing the category a person with multiple sclerosis is in may help doctors make more informed treatment decisions. For instance, since a patient who falls into the MSa category is more likely to experience relapse, her doctor may consider a stronger treatment for the patient.
In light of the discovery, the researchers remain cautious about the findings.
"Our study is an important step towards the goal of personalized medicine in MS, but much work remains to be done to understand under which circumstance and in combination with which other information this transcriptional signature may become useful in a clinical setting," said De Jager.
However, from the pre-clinical perspective, the researchers recognize that the findings are essential because they build on earlier studies that had suggested that this structure might be present.
"The study will further enable the community of MS researchers to build upon this transcriptional signature with other data in order to enhance patient care in the future," said De Jager.
This research was supported by the National Multiple Sclerosis Society, Fondazione Italiana Sclerosi Multipla, and the National Institutes of Health (R01 NS067305).
Brigham and Women's Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare. BWH has more than 3.5 million annual patient visits, is the largest birthing center in New England and employs nearly 15,000 people. The Brigham's medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in patient care, quality improvement and patient safety initiatives, and its dedication to research, innovation, community engagement and educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Biomedical Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, involving nearly 1,000 physician-investigators and renowned biomedical scientists and faculty supported by nearly $625 million in funding. BWH continually pushes the boundaries of medicine, including building on its legacy in organ transplantation by performing the first face transplants in the U.S. in 2011. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies, OurGenes and the Women's Health Initiative. For more information and resources, please visit BWH's online newsroom.
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