MS Research Spotlight: NfL Biomarker, Dysphagia & More

MS Research Spotlight covers key research news from the past two weeks.

Oxidative stress related to iron metabolism in RRMS patients with low disability

FEBRUARY 11, 2019 || Frontiers in Neuroscience

New research out of Italy suggests that obvious oxidative stress in MS patients is best measured using an index known as the Cp:Tf ratio to identify systemic inflammation related specifically to iron metabolism.

According to recent research published in Italy, clinical efforts to consolidate inflammatory biomarkers are lacking.

However, when individual oxidative stress markers are identified, this information can clarify and measure peripheral inflammation—which both leads to oxidative stress and is also the result it.

What is the Cp:Tf ratio?

The Cp:Tf ratio is key to unlocking this information.

Cp (ceruloplasmin) is a protein necessary for the metabolism of copper and iron, which also offers a strong antioxidant function.

Tf (transferrin) is a blood protein which binds iron; it is considered the most vital iron factor in the blood.

“An altered status of oxidative stress and/or antioxidant response is detectable in MS patients with low disability analyzed during a relapse-free period,” writes lead study author Dr. Mariacristina Siotto of Milan.

By measuring this Cp: Tf ratio, neurologists may be better equipped to monitor stress and employ antioxidant therapies in addition to immunotherapy which could reap greater benefits for those with MS.

Blood neurofilament light chain as a biomarker of MS disease activity & treatment response

FEBRUARY 8, 2019 || Neurology

People with MS may double take when they encounter references to the NfL, these days. The NfL is not only an acronym for a certain sports league, but also the nickname for blood neurofilament light chains.

Measures of NfL were recently identified as potential biomarkers for MS disease activity, with potential use as prognostic tools for tracking treatment responses, according to research in Neurology.

Real-time monitoring with minimal burden on the patient

“We have shown that blood NfL levels are closely related to clinical and MRI measures in patients with RRMS, which capture features of acute disease activity, worsening of disability, and tissue loss,” writes the study’s lead author, Jens Kuhle MD of University Hospital Basel.

Using blood tests to assess NfL places minimal burden on the patient, Kuhle said, while achieving real-time monitoring of demyelination activity and treatment response. Kuhle suggested that developing a database of NfL data shows promise in guiding more personalized treatment decisions in the future.

The effect of traditional dysphagia therapy on swallowing function

FEBRUARY 3, 2019 || Journal of Bodywork and Movement Therapies

A small study examined problems with swallowing (dysphagia), a common MS symptom, which can be dangerous due to complications such as dehydration, aspiration pneumonia and malnutrition.

According to sources cited in the study, at least a third of people with MS experience trouble with swallowing; it can impact quality of life and be especially disruptive during the final stages of disease.

Traditional dysphagia therapy

Researchers studied the efficacy of a therapy known as TDT, or traditional dysphagia therapy.

TDT is designed to improve the range of motion in and facilitate the coordination of the structures of the mouth and throat. Techniques include strategies to heighten sensory input during eating and drinking, swallowing maneuvers, and exercises to achieve better oral motor control.

The study determined that TDT significantly improved swallowing function while eating in its pool of MS subjects.

Usual care

Another therapy, usual care (UC), was found effective, if less so.

UC involves techniques that do not change swallowing physiology, but which strive to control food flow and prevent aspiration. These include postural changes, modification of food volume and the speed of feeding, changes in food consistency and viscosity, and improving sensory awareness when introducing food to the mouth.

The researchers acknowledged the sample size was low, at 20 participants, but encouraged future trials to compare dysphagia treatments.

Employing body-worn sensors to detect changes in balance & mobility

JANUARY 29, 2019 || International Journal of MS Care

Should people with MS who experience problems with gait and balance be concerned about getting aerobic exercise?

According to new research, not only is moderate-intensity (“acute”) aerobic exercise safe to perform in short (15-minute) intervals for people with MS, but significant improvements in balance and coordination of the stride were seen immediately following exercise periods.

The researchers concluded that “this study lends further evidence that individuals with MS… may actually receive some short-term benefit in regard to standing postural sway and gait variability” following single bouts of aerobic activity.

They suggest future investigations into aerobic exercise, such as the type, intensity, timing and amounts that could generate both short-term gains and better long-term health outcomes for people with MS.