"In some patients, it is difficult to conclusively diagnose MS," said Jagannadha Avasarala, M.D., Ph.D., lead researcher, who completed the study while at Wake Forest Baptist. "Identifying markers for disease has become a rapidly evolving science, particular in cancer diagnostics. In the field of MS, however, there have been no similar studies."
This is the first published report of a potential blood test for MS. For the study, the researchers compared blood samples from 25 patients who were newly diagnosed with MS with blood samples from 25 healthy people to see if there is a "fingerprint," or distinct pattern of proteins and peptides in people with MS. Proteins are made by genes, and the information locked in genes is "expressed" in proteins. Peptides are the building blocks of proteins.
Participants in the study had relapsing-remitting MS, the most common form, which is characterized by attacks interspersed with stable periods. They were not taking medications for MS. The mean age of participants with MS was 29 years; the healthy participants had a mean age of 28.
"In this preliminary investigation, we found a distinct pattern in the MS group that revealed the existence of three markers for the disease," said Avasarala, a neurologist. "This suggests the potential for developing a blood test that could allow us to identify the earliest changes that represent MS and help in its diagnosis."
Currently the disease is diagnosed through a combination of patient history, physical examination, magnetic resonance imaging (MRI) and laboratory testing, such as lumbar puncture. "MRI is an expensive tool that we might be able to avoid if a blood test can be developed for MS," said Avasarala. "There is probably not a single marker to detect MS. This test was designed to look for a pattern of individual proteins that can differential people with MS from healthy people."
The analysis combined mass spectrometry, a tool for analyzing proteins, with special software to recognize proteins patterns. The technology, known as BAMFTM, was developed by Predictive Diagnostics. Avasarala collaborated Michael Wall and Gershon Wolfe from the company, based in Vacaville, Calif.., to analyze the results.
The findings were presented in April at the American Academy of Neurology's annual meeting. Avasarla is currently collaborating with Wolfe, Wall and Thomas Burger from Innsbruck Medical University, Austria, to analyze 300 patient samples to identify the marker molecules.
MS is a disease of the central nervous system that affects the brain and spinal cord. It strikes an estimated 250,000 people in the United States and is a major acquired neurologic disease in young adults. Common signs and symptoms of MS include fatigue, psychological and cognitive changes, weakness or paralysis of limbs, numbness, vision problems, difficulties speaking or walking, bladder problems, and sexual dysfunction. Wake Forest Baptist cares for more than 2,000 patients with MS.
About Wake Forest University Baptist Medical Center: Wake Forest Baptist is an academic health system comprised of North Carolina Baptist Hospital and Wake Forest University Health Sciences, which operates the university's School of Medicine. The system comprises 1,282 acute care, psychiatric, rehabilitation and long-term care beds and is consistently ranked as one of "America's Best Hospitals" by U.S. News & World Report.