Simple test for Multiple Sclerosis.

The recently published news report entitled “Israeli researchers eye simple test for multiple sclerosis” (Nat. Med. 19, 1147; 2004) raises an important issue that deserves more accurate information for the benefit of your readers. The report correctly states that “an inexpensive, easily obtained barometer for monitoring disease activity in multiple sclerosis (MS) patients” is highly needed and that most methods are either too expensive or not sensitive enough. This is not correct: indeed, an extensive research effort over the past ten years at the University of Florence, Italy, has already yielded a prototype blood test for monitoring MS disease activity. The multiple sclerosis test I am referring to was described in an international patent application and in several communications in International Symposia. It is a simple immunoenzymatic assay based on a designed synthetic glycosylated peptide, which characterizes specific auto-antibodies that are present in the serum of MS patients. The glycosylated antigen was instrumental in isolating antibodies (specific for the sugar) from patients’ sera and these auto-antibodies were shown to recognize myelin and oligodendrocyte antigens in brain sections by immunohistochemistry. Finally, a large, unpublished validation study, conducted in collaboration with Italian neurological clinical units, showed that the test detects the presence of auto-antibodies in the sera of a cohort of MS patients, but not in patients affected by other autoimmune diseases. In an unpublished longitudinal study of untreated patients followed for up to six months, the glycopeptide was shown to be a reliable and specific probe: development of anti-glycopeptide antibodies paralleled clinical activity and brain lesions positive to Magnetic Resonance Imaging.