Study identifies three distinct immune signatures in people with MS which may predict disease course

Researchers investigating early multiple sclerosis (MS) have pinpointed three distinct immune profiles in patients’ bloodstreams, potentially paving the way for personalised treatment approaches.

The study was called ‘Multiple sclerosis endophenotypes identified by high-dimensional blood signatures are associated with distinct disease trajectories’, and published in Science Translational Medicine.

MS causes the immune system to attack nerve fibre coverings in the brain and spinal cord, resulting in diverse symptoms that vary between individuals.

Current treatment selection relies on disease activity and severity metrics but overlooks the nuanced immune responses underlying the condition. This knowledge gap hampers predicting disease trajectories and optimal medication responses.

By scrutinising participants’ immune profiles and leveraging machine learning, researchers identified three distinct MS subgroups characterised by unique immune signatures. These signatures remained consistent over nine years, affirming their intrinsic connection to each patient’s disease.

Two of the subgroups were labelled ‘inflammatory’ and ‘degenerative’. They exhibited differing disease courses and responses to treatments. Those in the inflammatory subgroup experienced heightened inflammatory activity, multiple relapses, and rapid disability accumulation. In contrast, the degenerative subgroup showed signs of brain damage, severe disease, cognitive impairment, and elevated nerve damage markers. The third subgroup needs further research to gather more details to be fully characterised.

Treatment responses also varied among groups, with interferon-based medications showing limited efficacy for the inflammatory subgroup compared to alternatives like glatiramer acetate and Tecfidera.

Dr. Luisa Klotz, co-lead researcher from the University of Münster, underscored the study’s potential to reshape treatment paradigms and enable clinicians to predict disease progression and treatment responses accurately. Pre-treatment immune signature assessments could personalise care, significantly enhancing MS patients’ quality of life.