MS Research Australia-supported researcher Dr Anne Bruestle, from the Australian National University, has been awarded a Ramaciotti Health Investment Grant. These grants are awarded to individuals in universities, public hospitals or institutes for a contribution towards the undertaking of health or medical research with the potential path to clinical application within five years.
MS manifests in 85% of people as a relapsing remitting form, characterised by relapses or attacks and periods of remission. Sometimes relapses can have no obvious symptoms, making them difficult to detect. These types of relapses remain important as they still contribute to damage to the myelin and nerves and can lead to further disability. Currently, magnetic resonance imaging (MRI) is the only way to visualise the effects of these types of relapses, but the level of screening that would be required makes it too expensive and not feasible. As such, there is an urgent need for biomarkers – a biological cue that can be measured – that may indicate the onset of a relapse.
So far, there is only one biomarker for the activity of MS called neurofilament light chain (NfL). This protein is normally found inside nerve cells where it acts as a skeleton for the cells. As nerve cells die, this protein is released into the spinal fluid and bloodstream and can be used as a measure of damage that is occurring in the brain. This makes NfL an attractive biomarker for MS that can be continuously monitored. This would enable earlier detection of treatment failure that could be acted upon quickly, reducing further damage to the brain and spinal cord. However, NfL cannot be used to predict and therefore prevent all symptomless relapses. It’s necessary to find a predictive biomarker that is elevated prior to a relapse to allow timely medical intervention. Dr Bruestle has found structures in the blood of people with MS called neutrophil extracellular traps (NETs). These are released by a type of white blood cell called neutrophils and peak just before the onset of a relapse in laboratory models.
Dr Bruestle will work with Professor Antonio Tricoli, who has developed novel electrochemical sensing technology, for the rapid detection of NfL and NETs in blood from people with MS. This project will validate and translate NfL and NETs as blood indicators for MS relapses. Dr Bruestle will also collaborate with clinicians and researchers from other disciplines, meaning this project is directly transferrable to the clinic.
This work will offer an innovative and practical strategy for predicting and sensing symptomless relapses in MS, which until now has been impossible. Sensing or even predicting symptomless relapses would enable early detection of treatment failure without waiting for the first clinical signs. People with MS could then be changed to a more effective treatment option, leading to less overall damage to the brain cells and subsequently less accumulated disability.