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2 Types of MS, Study Reveals

Blood Test Would Predict Success of Multiple Sclerosis Treatment

Two Routes to MS continued...

Humans, too, appear to have different kinds of MS. Steinman and colleagues tested blood samples taken before treatment from 26 MS patients. Six of the 12 patients who did not respond to beta interferon had high levels of Th17 in their blood.

These patients with Th17 immune responses also had high levels of beta interferon in their blood -- before beta interferon treatment.  That means one of two things:

  • In patients with Th17-type MS, beta interferon doesn't help because beta interferon levels already are high.
  • In patients with Th17-type MS, beta interferon doesn't fight inflammation -- it makes inflammation worse. In this case, just as in mice with Th17-induced disease, beta interferon would exacerbate MS.

New Hope for MS Patients

"We are very excited about this kind of discovery, because there are new therapy approaches that focus on Th17 immune pathways," Yeaman tells WebMD. "We don't know the answers yet, but we are starting to see the dots on the page -- and if we can connect the dots, perhaps a new treatment or cure can emerge."

People with MS are likely to see a benefit long before new treatments emerge. Blood tests already exist that can tell MS patients whether they have Th1 or Th17 disease. Those with Th17 disease can be spared having to undergo the side effects of beta interferon treatment, while those with Th1 disease can endure side effects knowing that the treatment is highly likely to work.

"When first diagnosed with MS, the first question a person asks is, 'What can I expect? How bad will it be?'" O'Looney says. "It would it be great if we can identify something to say, 'This person has this makeup and 10 years from now may be OK, or that person may need more aggressive therapy."

Despite their enthusiasm over the new findings, all of the experts consulted for this article caution that the new findings must be validated in large numbers of MS patients. All warn that it's too soon for patients to seek testing or to make treatment decisions on the basis of these preliminary findings.

The study findings appear in the March 28 advance online issue of Nature Medicine.


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