Blood Test Detects Multiple Sclerosis Risk Years Before Onset of Symptoms

8 million people worldwide. Its development is linked to immunological processes triggered by Epstein-Barr virus (EBV) infection. Though the virus is widespread, present in 90-95% of the population, MS remains difficult to diagnose early due to the lack of clear symptoms in its early stages. MS typically manifests years after the initial EBV infection, making it challenging to predict and treat the disease before symptoms appear. Current diagnostic methods, such as neurofilament light chain (NfL) or glial fibrillary acidic protein (GFAP) levels, only detect nerve cell damage later in the disease process. Now, a new blood test enables accurate identification of individuals at risk for developing MS years before the onset of symptoms.

The blood test developed by researchers at the Medical University of Vienna (Vienna, Austria) detects autoantibodies that react to both the EBV protein EBNA-1 and structures in the human brain. These antibodies can be detected within three years of an EBV infection, long before clinical symptoms of MS appear. The test identifies individuals at higher risk for MS by repeatedly measuring the levels of these antibodies. The test could be used to track individuals who are at a higher risk of developing MS in the coming years. This breakthrough could enable early intervention, potentially delaying or even preventing the onset of MS.

The test was validated through a retrospective study involving over 700 MS patients and more than 5,000 control subjects. The research team was able to trace back to the time of initial EBV infection in some participants, and monitor the development of MS over time. Consistently high antibody levels were linked to a significantly elevated risk of developing MS and rapid disease progression, according to findings published in Nature Communications. The researchers suggest that the test could be used for screening populations at increased risk for MS, such as those with a history of Infectious Mononucleosis. However, further studies are required before the test can be implemented in clinical practice.

"Our study shows that, when using this antibody assay, the development of MS becomes immunologically predictable long before the first symptoms appear," said study leader Elisabeth Puchhammer-Stöckl.