Emergence of antibodies as biomarkers in multiple sclerosis

Rather than being a homogenous disease entity, multiple sclerosis (MS) represents a family of heterogenous inflammatory-demyelinating CNS diseases. The heterogeneity is demonstrated by various well known clinical disease courses and, more importantly, by inhomogenous and unpredictable therapeutic effects. Recent neuropathological evidence has initiated a process of re-evaluation of the immunopathogenetic concepts in MS. The heterogeneity of MS claims to subtype our patients more distinctively in the future by genetic, clinical, neuroradiological and neuroimmunological parameters. Therefore, the importance of identifiying biological markers in MS has evolved over the past few years. This review discusses 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 serving as biomarkers will create the future path for establishing a differential therapeutic concept in MS, which will allow the treatment of individuals selectively, according to their pathogenetic subtype and disease status.