Proteins Indicate Relapse and Response
Rus and Cosmin Tegla, MD, of the division of hematology and oncology at New York University Langone Health received a patent for a blood-based biomarker in May. The new biomarker analyzes proteins in a patient’s blood, including Sirtuin 1, Response Gene to Complement-32, Fas ligand and interleukin21.
“The biomarker will be a replacement for the brain MRI,” Rus told U.S. Medicine, and it will be “far less expensive.”
The researchers previously published studies of 15 patients over two years that demonstrated the ability of the proteins to identify patients experiencing a relapse and response to therapy.
They found that SIRT1 messenger RNA is lower in the peripheral blood mononuclear cells of patients with multiple sclerosis who are experiencing a relapse than in those with stable disease. In addition, patients who responded to treatment with glatiramer acetate, a common therapy for MS, had higher SIRT1 mRNA than nonresponders.1 The study defined nonresponders as participants who had two or more relapses after starting treatment with glatiramer acetate. Overall, SIRT1 mRNA had a 70% probability of accurately predicting response to the therapy.
The Maryland team also found that expression of RGC-32 and FAsL declined and IL-21 increased during acute relapses. Participants who responded to glatiramer acetate showed increased expression of both RGC-32 and FasL and reduced expression of IL-21. RGC-32 had a 90% probability of accurately detecting a relapse and 85% accurate for detecting response to glatiramer acetate, while FasL was 99% and 90% and IL-21 75% and 85% accurate for the two statuses, respectively.
“The test can be used to monitor response to therapy and distinguish between responders and nonresponders to MS therapy based on its levels in the blood,” Rus explained. “If a patient has a relapse, then he will need to be switched from the MS therapy he is taking to a new one.”
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