Multiple sclerosis: Disease biomarkers as indicated by pathophysiology

Multiple sclerosis (MS), the most important human inflammatory demyelinating disease of the central nervous system, is characterized by heterouenous genetic backgrounds and immunopathogenetic subtypes, various clinical disease courses, and inhortiogencous and unpredictable therapeutic effects. Because of this heterogeneity, subtyping of our MS patients by genetical, clinical, neuroradiological, and neurounimmological parameters will be an urgent need in the near future. Therefore the importance of identifying biological markers for MS has evolved over the past years. Evidence for a possible role of antibodies as biological markers for MS comes from several studies indicating that intrathecal antibody production and the dorninance of B-cells are associated with a more progressive disease course. This review summarizes the current status and potential applicability of antibodies as biological markers for the diagnosis, classification, disease activity and prediction of clinical courses in MS. Antibodies (and other molecules) serving as biomarkers will help to establish a differential therapeutic concept in MS, which should allow to treat individuals selectively according to their pathogenetic subtype and disease status. (C) 2007 Elsevier B.V All rights reserved.