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Review
. 2025 Jul;22(4):e00588.
doi: 10.1016/j.neurot.2025.e00588. Epub 2025 Apr 19.

Role of soluble biomarkers in treating multiple sclerosis and neuroinflammatory conditions

Gauruv Bose  1 , Simon D X Thebault  2 , Giulia Fadda  3 , John A Brooks  3 , Mark S Freedman  3
Affiliations
Review

Role of soluble biomarkers in treating multiple sclerosis and neuroinflammatory conditions

Gauruv Bose et al. Neurotherapeutics. 2025 Jul.

Abstract

Multiple sclerosis (MS) is a complex, chronic immune-mediated disease characterized by acute and progressive inflammatory damage of the central nervous system. MS manifests clinically with unpredictable neurological symptoms from focal inflammatory attacks as well as gradual neurodegeneration which contribute significantly to long-term disability progression. As treatment options advance, developing more personalized strategies capture heterogeneous mechanisms of injury which may be targeted or predict outcomes has been a focus of ongoing investigation. The role of soluble biomarkers has emerged as a pivotal tool to assist in these goals. Early promising candidates include neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP); these intermediate filaments that are expressed in neurons and astrocytes, respectively, are reliably measurable from blood samples and can reveal clinical and subclinical changes, as well as predict progression. Changes in these biomarkers can indicate a response to therapy, thus potentially be used as endpoints in clinical trials. Furthermore, recent research has identified a potential role of these and other soluble biomarkers in other neuroimmunological conditions including neuromyelitis spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein associated disease (MOGAD), autoimmune encephalitis, neurosarcoidosis, neuropsychiatric involvement in connective tissue disorders and vasculitides, and a host of neurodegenerative conditions. By integrating biomarker analysis into routine clinical assessments, healthcare providers may move toward a more nuanced and individualized care model, better equipped to meet the challenges posed by these multifaceted diseases. Understanding the dynamics of these biomarkers has many applications that can improve personalized medicine in MS.

Keywords: Biomarkers; Diagnosis; Multiple sclerosis; Neurofilament; Neuroinflammation; Prediction.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Gauruv Bose reports a relationship with Novartis Pharmaceuticals that includes: consulting or advisory and speaking and lecture fees. Simon Thebault reports a relationship with Novartis Pharmaceuticals that includes: consulting or advisory and speaking and lecture fees. Giulia Fadda reports a relationship with Novartis Pharmaceuticals that includes: consulting or advisory and speaking and lecture fees. Mark S. Freedman reports a relationship with Novartis Pharmaceuticals that includes: consulting or advisory and speaking and lecture fees. Gauruv Bose reports a relationship with EMD Serono Canada Inc that includes: consulting or advisory, speaking and lecture fees, and travel reimbursement. Gauruv Bose reports a relationship with Sanofi Genzyme Canada that includes: consulting or advisory, speaking and lecture fees, and travel reimbursement. Gauruv Bose reports a relationship with TEVA Pharmaceuticals that includes: speaking and lecture fees. Gauruv Bose reports a relationship with Multiple Sclerosis Society of Canada that includes: funding grants. Gauruv Bose reports a relationship with Innovation Fund that includes: funding grants. Gauruv Bose reports a relationship with Ontario Centre of Innovation that includes: funding grants. Simon Thebault reports a relationship with Sanofi Genzyme Canada that includes: consulting or advisory. Simon Thebault reports a relationship with Siemens Healthineers that includes: consulting or advisory. Simon Thebault reports a relationship with Innovation Fund that includes: funding grants. Simon Thebault reports a relationship with Multiple Sclerosis Society of Canada that includes: funding grants. Simon Thebault reports a relationship with American Brain Foundation that includes: funding grants. Giulia Fadda reports a relationship with Horizon Therapeutics Canada that includes: consulting or advisory. Giulia Fadda reports a relationship with American Brain Foundation that includes: funding grants. Giulia Fadda reports a relationship with Brain Canada Foundation that includes: funding grants. Mark S. Freedman reports a relationship with Sanofi Genzyme Canada that includes: board membership, consulting or advisory, funding grants, speaking and lecture fees, and travel reimbursement. Mark S. Freedman reports a relationship with Alexion that includes: board membership, consulting or advisory, and speaking and lecture fees. Mark S. Freedman reports a relationship with EMD Serono Canada Inc that includes: board membership, consulting or advisory, speaking and lecture fees, and travel reimbursement. Mark S. Freedman reports a relationship with Roche Pharmaceuticals - Hoffmann - La Roche Ltd that includes: board membership, consulting or advisory, and speaking and lecture fees. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Schematic of soluble biomarkers in multiple sclerosis.
Fig. 2
Fig. 2
Clinical roles of soluble biomarkers in treating multiple sclerosis.
See this image and copyright information in PMC

References

    1. Kuhlmann T., Moccia M., Coetzee T., Cohen J.A., Correale J., Graves J., et al. Multiple sclerosis progression: time for a new mechanism-driven framework. Lancet Neurol. 2023 Jan;22(1):78–88. - PMC - PubMed
    1. Walton C., King R., Rechtman L., Kaye W., Leray E., Marrie R.A., et al. Rising prevalence of multiple sclerosis worldwide: insights from the Atlas of MS, third edition. Multiple Sclerosis Journal. 2020 Dec 11;26(14):1816–1821. - PMC - PubMed
    1. Bose G., Freedman M.S. Precision medicine in the multiple sclerosis clinic: selecting the right patient for the right treatment. Multiple Sclerosis Journal [Internet] 2020 Apr 22;26(5):540–547. http://journals.sagepub.com/doi/10.1177/1352458519887324 Available from: - DOI - PubMed
    1. Chitnis T., Prat A. A roadmap to precision medicine for multiple sclerosis. Multiple Sclerosis Journal [Internet] 2020 Apr 22;26(5):522–532. http://journals.sagepub.com/doi/10.1177/1352458519881558 Available from: - DOI - PubMed
    1. Thebault S., Bose G., Booth R., Freedman M.S. Serum neurofilament light in MS: the first true blood-based biomarker? Multiple Sclerosis Journal [Internet] 2021 Feb 10 http://journals.sagepub.com/doi/10.1177/1352458521993066 Available from: - DOI - PMC - PubMed

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