Multiple sclerosis (MS) is a notoriously difficult disease to manage. It can advance from a more benign relapsing-remitting disorder to an aggressively progressive one, but there is no way to pinpoint when and in which patients this downturn will occur. Moreover, there are currently no treatments available for the more severe progressive form of the disease.
Katerina Akassoglou, PhD, a senior investigator at the Gladstone Institutes, seeks to solve this problem by identifying a biomarker for MS in the blood that can track the progression of the disease. This initiative has the potential to completely transform the diagnosis and care of MS, while also aiding in the development of new therapies and improving clinical trials.
“Right now, the transition from relapsing-remitting to progressive MS is completely unpredictable—it can take two years or twenty years—and this makes a big difference in how aggressively you treat a patient,” explains Dr. Akassoglou, who is also a professor of neurology at the University of California, San Francisco. “A blood biomarker for MS would provide a more concrete and convenient way to measure how much the disease has advanced or improved with treatment, and it could also shed light on how this progression occurs.”
Thanks to a recent grant from the Conrad N. Hilton Foundation—the Marilyn Hilton Award for Innovation in MS Research, the first to be awarded from the Foundation for MS, with the goal of stimulating innovative and potentially paradigm-shifting research—Dr. Akassoglou will investigate whether certain proteins found in the blood can be useful in tracking the progression of the disease in patients.
Previous research by Dr. Akassoglou revealed that MS is linked to elevated levels of blood clotting-related proteins in the brain. While these proteins are important components of the so-called coagulation cascade that aids in normal blood clotting, their presence in the brain triggers harmful inflammation. Using mouse models of MS, Dr. Akassoglou has shown that higher levels of these proteins are early indicators of MS and key contributors to neuron damage, resulting in disease progression.
Now, in collaboration with Jorge Oksenberg, PhD, a professor of neurology at UCSF, Dr. Akassoglou will use the EPIC (Expression, Proteomics, Imaging, Clinical) database to test for these blood-clotting proteins in a group of MS patients. EPIC is a longitudinal study at UCSF that is tracking nearly 600 patients for ten years using clinical evaluations, blood draws, imaging data, and full genome sequencing.
“The EPIC dataset provides us with a unique window into the natural history of the disease,” says Dr. Oksenberg. “There has never before been a test of a biomarker in a cohort that has so much information accumulated, making it the ideal sample for Dr. Akassoglou to test her hypothesis. We will be able to establish how protein levels in the blood taken at the very early stages of MS correlate with how the disease behaves ten years down the road, juxtaposing the biomarker with clinical, genetic, and imaging data already available.”
“It’s a great honor to be acknowledged by the Hilton Foundation for this research,” adds Dr. Akassoglou. “We are very excited to test our hypothesis directly on clinical samples, as it could open new avenues for diagnosis and the development of treatments for progressive MS.”