The MSVirtual2020 late breaking news was announced this weekend. Despite a diagnostic biomarker for neuromyelitis optica (the Aquaporin 4 antibody), it remains difficult differentiate NMO from MS clinically.
Dr David Leppert from Basel, Switzerland presented their findings on biomarkers of the innate immune system, focusing on neutrophil activity markers (a type of immune cell) in the cerebrospinal fluid (CSF). They present tantalizing data on these activity markers as potential differentiators of MS and NMO.
As very little work has been done before on this, they asked the following questions:
Their analysis that CSF GFAP was a useful biomarker for differentiating NMO from MS at a group level. They postulated that samples taken during an acute relapse may even be of use at an individual level (see below).
Moreover, neutrophil markers Elastace and neutrophil gelatinase-associated lipocalin had the ability to differentiate acute NMO from acute MS with enough sensitivity to be clinically useful (see below).
The only limitation of this work is the relatively small sample size. The data would need to be reproduced on a larger scale. However, if these biomarkers can be checked quickly (unlike the Aquaporin 4 antibody), then the appropriate treatment can be instituted for either MS or NMO within days of the admission.