MS is a complex disease that can affect people in different ways. The three main types are relapsing-remitting, primary-progressive and secondary-progressive.
While primary progressive MS occurs in about 15 to 20 per cent of patients, relapsing-remitting is the presenting form of MS in about 80 per cent of patients. It has been estimated that, after 20 years, 50 to 60 per cent of patients with relapsing-remitting MS shift towards the secondary progressive form.
The transition from relapsing-remitting to secondary progressive MS occurs subtly and is hard to define clinically.
Finding ways to distinguish between the different clinical subtypes of MS is important to ensure that the appropriate treatments are adopted in a timely fashion.
A study by researchers from Oxford and Cambridge Universities found a new way to distinguish between relapsing-remitting and secondary-progressive MS. They found that each type of MS had a specific profile of certain substances in the blood, called metabolites, detected by spectroscopic magnetic resonance and complex mathematical analysis.
The researchers collected blood samples from 151 patients with MS, which they scanned with an imaging technique called magnetic resonance spectroscopy.
Characteristic metabolite patterns were identified in blood samples from patients with MS compared with either healthy volunteers or people with other neurological disorders.
This is a very sensitive way to predict the conversion from relapsing-remitting to secondary-progressive MS, potentially helping neurologists choose the right treatment in patients with an uncertain type of MS.
Furthermore, this approach may identify key metabolites involved in the transition from relapsing-remitting to progressive MS, and help find targets for the development of novel therapeutics.