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Biomarkers in MS - brief clip on what they are..
Quick/brief clip on Biomarkers in MS below, i.e., what they are (briefly), and why they are important. Be sure to scroll all the way down, and click on clip. It's not specific to what biomarkers have been identified already for certain meds -- it's just a simple intro on what a biomarker is.
http://conferences.msworld.org/ectrims-2011/day-two/biomarkers-in-ms
http://conferences.msworld.org/ectrims-2011/day-two/biomarkers-in-ms
Thanks Shelly and Lulu.
I didn't know anything about bookmakers before reading these posts. It sounds so promising. What a relief it will be to eventually have the ability to predict which DMD will have the best results for individuals with MS.
It really is exciting to hear about all the progress being made!
Deb
I didn't know anything about bookmakers before reading these posts. It sounds so promising. What a relief it will be to eventually have the ability to predict which DMD will have the best results for individuals with MS.
It really is exciting to hear about all the progress being made!
Deb
thanks for the simplified site, however, I hope all breeze through the interview above because there are answers to questions we all have, i.e.,
How this will help doctors patients, decision making, and the timeline, and the useful means by which biomarkers are identified.
How this will help doctors patients, decision making, and the timeline, and the useful means by which biomarkers are identified.
there is a simplified explanation of biomarkers, what they are and how they can be used for MS in the current issue of MS Perspectives. You can access the current issue at
http://www.msperspectives.com/
The story is on page 4.
Thanks for keeping us current on this topic, Shell. It's exciting to know it will help to tailor customi
http://www.msperspectives.com/
The story is on page 4.
Thanks for keeping us current on this topic, Shell. It's exciting to know it will help to tailor customi
This is an interview transcript from the ECTRIMS conference:
It's a good introduction to biomarkers.
_______________________________________
Editor's note:
At the 5th Triennial Congress of the European and Americas Committees for Treatment and Research in Multiple Sclerosis in Amsterdam, The Netherlands, Andrew N. Wilner, MD, interviewed Charlotte Teunissen, PhD, Assistant Professor and Head of Neurological Laboratory and Biobank of the Department of Clinical Chemistry at Vrije Universiteit University Medical Center in Amsterdam, on advances in biomarker diagnostics for multiple sclerosis.
Biomarkers in MS: Introduction
Andrew N. Wilner, MD: Here at the ECTRIMS conference, there's a lot of emphasis on biomarkers for multiple sclerosis (MS). Are practicing neurologists using any biomarkers at the moment?
Charlotte Teunissen, PhD: There are oligoclonal bands being used to discriminate MS patients from controls, and they're rather sensitive for MS -- above 90%. They are also very stable.
Dr. Wilner: So they're very sensitive, but not very specific. There are many other neurologic diseases in which oligoclonal bands can occur.
Dr. Teunissen: Yes, that's true. We find that using MRI measures and oligoclonal bands reduces [diagnostic uncertainty]. But this is also a controversial issue currently.
Dr. Wilner: So, what is a biomarker?
Dr. Teunissen: A biomarker is defined as an objective indicator of biological processes in a disease state or a pathological process, or of response to a treatment. For early diagnosis we [already have] very well-established diagnostic criteria. However, for very early diagnosis or risk prediction -- and also for early therapy response prediction -- they could be very valuable.
Dr. Wilner: So right now we have many new treatment options in MS, which we're hearing a lot about at this meeting. But the physician who is face to face with a patient still doesn't have too many clues about which one to choose for a given patient. Could a biomarker be helpful?
Dr. Teunissen: Well, that's one of our aims -- to be able to predict in a relatively short time or beforehand whether our patients will respond to therapy A or therapy B. That would be ideal. I think less ideal, but also very interesting, would be if a response can be predicted after just 1 or 2 months of treatment -- whether there is a relevant biological response or not. Because now doctors evaluate the response to a therapy at a half year or longer.
Dr. Wilner: What kind of physiologic responses could be measured? Is it something in the blood or the spinal fluid?
Dr. Teunissen: Yes. Spinal fluid would be ideal, and that's where most of the current studies are looking. I'm talking mostly about proteomics discovery here.
Dr. Wilner: Researchers have been throwing around this word "proteomics" all week at this conference. Can you tell us what it means exactly?
Dr. Teunissen: For our purposes, all proteins within the cerebrospinal fluid [CSF] are called the proteomes. And all proteins, or the whole proteome, of the cerebrospinal fluid of MS patients are being compared to controls. And this activity is called proteomics, and there are specific tools being used for proteomics. It can be gel-based, also chromatography-based, and there are other methods as well. But the main feature is that all proteins are being compared. [Editor's note: Broadly speaking, a "proteome" refers to all of the proteins expressed and/or present by/in a genome, organism, or tissue.].
Currently, proteomics methods are sensitive enough to measure about 1000 different proteins in CSF simultaneously. So some may be different between MS and controls. You look at the peak concentration and the identity of these proteins to determine if they might be new biomarkers.
Dr. Wilner: Are there any proteins in the spinal fluid of MS patients that are unique to those patients'?
Dr. Teunissen: I have not seen them yet.
Dr. Wilner: So it's more of a question of the amount?
Dr. Teunissen: Yes. Differences in concentration. Though [biomarkers only present in] patients with MS could be possible.
Dr. Wilner: If you didn't know what you were looking for, would you be able to find it?
Dr. Teunissen: Yes, because the technology allows us to look at all proteins. Mass spectrometry will define the identity of the proteins.
Dr. Wilner: For the neurologist in practice, from a pragmatic point of view what do you think will be the first tool that becomes available in the way of biomarkers, excluding the MRI because, of course, we use the MRI now? What do you think will be the next available biomarker?
Dr. Teunissen: I cannot predict it yet. I've seen several interesting candidates from the proteomic studies and also from other studies, which I think should be replicated in larger studies. We should also explore [ways of detecting biomarkers] not only in the CSF, but also in the blood.
Dr. Wilner: The patients would prefer that.
Dr. Teunissen: Yes, I know -- it is more difficult to look at the blood -- but we are very much aware of that. We need very highly sensitive methods to be able to measure neurospecific proteins in the blood.
However, I'm quite optimistic and I've seen an example -- a typical sterol and cholesterol family member, go from the brain parenchyma directly into the blood, with 1% being found in the CSF. So this strengthens my idea that there are neurospecific proteins that go directly into the blood. Current blood proteomic methods are quite difficult due to artifacts, but new methods and ELISA [enzyme-linked immunosorbent assay]-based methods are emerging.
Dr. Wilner: Do you think the first biomarker will be one that helps us make the diagnosis or one that helps us monitor a response to treatment?
Dr. Teunissen: I think the community will work hardest on monitoring or predicting response to a treatment.
Dr. Wilner: And are we looking at 1 year, 5 years, or 10 years?
Dr. Teunissen: I don't know. I'm afraid it's 5 to 10 years.
Dr. Wilner: So it's not something we're going to see at next year's ECTRIMS, but there is major effort in this area.
Dr. Teunissen: Yes. We still need a lot of validation studies, which are most possible within international collaborations. Thankfully, consortia have formed already and people are willing to collaborate. There are more and more guidelines for standardized procedures for cerebrospinal fluid collection, blood collection, and storage, which allow us to collaborate better. And so there will be many more opportunities for validation of new biomarkers.
This info is from the 5th conference which was in 2011.
-Shell
It's a good introduction to biomarkers.
_______________________________________
Editor's note:
At the 5th Triennial Congress of the European and Americas Committees for Treatment and Research in Multiple Sclerosis in Amsterdam, The Netherlands, Andrew N. Wilner, MD, interviewed Charlotte Teunissen, PhD, Assistant Professor and Head of Neurological Laboratory and Biobank of the Department of Clinical Chemistry at Vrije Universiteit University Medical Center in Amsterdam, on advances in biomarker diagnostics for multiple sclerosis.
Biomarkers in MS: Introduction
Andrew N. Wilner, MD: Here at the ECTRIMS conference, there's a lot of emphasis on biomarkers for multiple sclerosis (MS). Are practicing neurologists using any biomarkers at the moment?
Charlotte Teunissen, PhD: There are oligoclonal bands being used to discriminate MS patients from controls, and they're rather sensitive for MS -- above 90%. They are also very stable.
Dr. Wilner: So they're very sensitive, but not very specific. There are many other neurologic diseases in which oligoclonal bands can occur.
Dr. Teunissen: Yes, that's true. We find that using MRI measures and oligoclonal bands reduces [diagnostic uncertainty]. But this is also a controversial issue currently.
Dr. Wilner: So, what is a biomarker?
Dr. Teunissen: A biomarker is defined as an objective indicator of biological processes in a disease state or a pathological process, or of response to a treatment. For early diagnosis we [already have] very well-established diagnostic criteria. However, for very early diagnosis or risk prediction -- and also for early therapy response prediction -- they could be very valuable.
Dr. Wilner: So right now we have many new treatment options in MS, which we're hearing a lot about at this meeting. But the physician who is face to face with a patient still doesn't have too many clues about which one to choose for a given patient. Could a biomarker be helpful?
Dr. Teunissen: Well, that's one of our aims -- to be able to predict in a relatively short time or beforehand whether our patients will respond to therapy A or therapy B. That would be ideal. I think less ideal, but also very interesting, would be if a response can be predicted after just 1 or 2 months of treatment -- whether there is a relevant biological response or not. Because now doctors evaluate the response to a therapy at a half year or longer.
Dr. Wilner: What kind of physiologic responses could be measured? Is it something in the blood or the spinal fluid?
Dr. Teunissen: Yes. Spinal fluid would be ideal, and that's where most of the current studies are looking. I'm talking mostly about proteomics discovery here.
Dr. Wilner: Researchers have been throwing around this word "proteomics" all week at this conference. Can you tell us what it means exactly?
Dr. Teunissen: For our purposes, all proteins within the cerebrospinal fluid [CSF] are called the proteomes. And all proteins, or the whole proteome, of the cerebrospinal fluid of MS patients are being compared to controls. And this activity is called proteomics, and there are specific tools being used for proteomics. It can be gel-based, also chromatography-based, and there are other methods as well. But the main feature is that all proteins are being compared. [Editor's note: Broadly speaking, a "proteome" refers to all of the proteins expressed and/or present by/in a genome, organism, or tissue.].
Currently, proteomics methods are sensitive enough to measure about 1000 different proteins in CSF simultaneously. So some may be different between MS and controls. You look at the peak concentration and the identity of these proteins to determine if they might be new biomarkers.
Dr. Wilner: Are there any proteins in the spinal fluid of MS patients that are unique to those patients'?
Dr. Teunissen: I have not seen them yet.
Dr. Wilner: So it's more of a question of the amount?
Dr. Teunissen: Yes. Differences in concentration. Though [biomarkers only present in] patients with MS could be possible.
Dr. Wilner: If you didn't know what you were looking for, would you be able to find it?
Dr. Teunissen: Yes, because the technology allows us to look at all proteins. Mass spectrometry will define the identity of the proteins.
Dr. Wilner: For the neurologist in practice, from a pragmatic point of view what do you think will be the first tool that becomes available in the way of biomarkers, excluding the MRI because, of course, we use the MRI now? What do you think will be the next available biomarker?
Dr. Teunissen: I cannot predict it yet. I've seen several interesting candidates from the proteomic studies and also from other studies, which I think should be replicated in larger studies. We should also explore [ways of detecting biomarkers] not only in the CSF, but also in the blood.
Dr. Wilner: The patients would prefer that.
Dr. Teunissen: Yes, I know -- it is more difficult to look at the blood -- but we are very much aware of that. We need very highly sensitive methods to be able to measure neurospecific proteins in the blood.
However, I'm quite optimistic and I've seen an example -- a typical sterol and cholesterol family member, go from the brain parenchyma directly into the blood, with 1% being found in the CSF. So this strengthens my idea that there are neurospecific proteins that go directly into the blood. Current blood proteomic methods are quite difficult due to artifacts, but new methods and ELISA [enzyme-linked immunosorbent assay]-based methods are emerging.
Dr. Wilner: Do you think the first biomarker will be one that helps us make the diagnosis or one that helps us monitor a response to treatment?
Dr. Teunissen: I think the community will work hardest on monitoring or predicting response to a treatment.
Dr. Wilner: And are we looking at 1 year, 5 years, or 10 years?
Dr. Teunissen: I don't know. I'm afraid it's 5 to 10 years.
Dr. Wilner: So it's not something we're going to see at next year's ECTRIMS, but there is major effort in this area.
Dr. Teunissen: Yes. We still need a lot of validation studies, which are most possible within international collaborations. Thankfully, consortia have formed already and people are willing to collaborate. There are more and more guidelines for standardized procedures for cerebrospinal fluid collection, blood collection, and storage, which allow us to collaborate better. And so there will be many more opportunities for validation of new biomarkers.
This info is from the 5th conference which was in 2011.
-Shell
Dagnappid! Seems that old link is not working any more! Stand-by and I'll get a brandy new one! Geesh, figures!
-shell
-shell
In time, we will know more of who will respond to specific disease modifiers, making our decisions a little easier, and less time spend trying one and then another. This problems is not new to medicine obviously, there are tons of meds that we have to "try" and see if they work.
But, all should be at least familiar with what a biomarker is, and why it is important. Please see the above link, and I hope to expand on this discussion with more information in the near future.
-shell
But, all should be at least familiar with what a biomarker is, and why it is important. Please see the above link, and I hope to expand on this discussion with more information in the near future.
-shell
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