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Two novel biomarkers, lysosome-associated membrane glycoprotein 2 and insulin-like growth factor-binding protein 7, are effective in the diagnosis of multiple sclerosis and neuromyelitis optica spectrum disorder, the latter being associated with superior diagnostic potential.

Currently, no tests can establish a definitive diagnosis or differentiate between neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS). The current study evaluated novel biomarkers’ diagnostic potential, including lysosome-associated membrane glycoprotein 2 (LAMP2) and insulin-like growth factor-binding protein 7 (IGFBP7), in MS and NMOSD patients. The study concluded that the two biomarkers effectively predicted disease progression in MS patients and that IGFBP7 had superior diagnostic potential for NMOSD and MS. The study findings are published in the journal Diagnostics (Basel, Switzerland).

Characteristics of Study Participants and Protocol

The study investigators obtained serum and cerebrospinal fluid (CSF) samples from 20 healthy controls, 20 MS patients, 20 NMOSD patients, and 20 non-inflammatory neurological controls (NINC). A commercial enzyme-linked immunosorbent assay (ELISA) kit was utilized for the confirmation of the selected proteins. Among the different proteins identified during the proteomic analysis of CSF samples from MS and NMOSD patients, IGFBP7 and LAMP2 were identified as potential candidate proteins to serve as novel biomarkers in diagnosing MS and NMOSD.

 IGFBP7 Levels Were Higher in MS Patients 

Compared to NMOSD patients, the levels of IGFBP7 were significantly higher in the CSF and serum samples of MS patients. The levels of IGFBP7 were considerably higher in MS and NMOSD compared to NINC groups, with relatively higher levels in the CSF samples. However, the study investigators observed no changes in the protein expression of LAMP2 across CSF and serum samples in the MS and NMOSD groups.

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Correlation Between Protein Profiles of Serum and CSF Samples

Compared to the NMOSD cohort, there was a considerable positive correlation between the IGFBP7 levels in the serum and CSF in the MS cohort. Neither the MS nor NMOSD groups demonstrated a correlation in the LAMP2 levels in CSF or serum samples.

Diagnostic Efficacy of LAMP2 and IGFBP7 in MS and NMOSD

The study demonstrated that serum and CSF IGFBP7 had excellent sensitivity and specificity in diagnosing NMOSD and MS. Serum LAMP2 and IGFBP7 were also effective in predicting developing MS phenotypes. The study also concluded that CSF IGFBP7 is integral to diagnosing MS. However, this biomarker was not sufficient to distinguish between MS and NMOSD.

In summary, LAMP2 and IGFBP7 biomarkers are effective in predicting the progression of disease in MS patients. IGFBP7 has superior diagnostic potential for NMOSD and MS; however, its role in discriminating between MS and NMOSD has yet to be established.

Source:

Xu, T., Shi, Y., Zheng, G., & Zhang, G. (2023). Diagnostic Potential of Two Novel Biomarkers for Neuromyelitis Optica Spectrum Disorder and Multiple Sclerosis. Diagnostics, 13(9), 1572. https://doi.org/10.3390/diagnostics13091572