A large proteomic study showed that biological signs of multiple sclerosis (MS) begin years before symptoms appear. Myelin injury was detected about seven years before onset, followed by axonal damage one year later and astrocytic involvement only at clinical onset. Early activation of interleukin-3 and NF-κB pathways indicated immune activity during the presymptomatic stage. A 21-protein panel identified individuals with presymptomatic MS with 91% sensitivity and 65% specificity. The findings suggest a long biological initiation phase for MS, offering potential for earlier detection, though validation in broader cohorts is needed.

Source: Nature Medicine