Science News: Rise of Biomarkers - Part 2

Submitted by Francisco Gomez, MD, News Science Editorial Board
Over the past several months, an ever increasing number of articles on biomarkers have been published. The AANEM News Science Editorial Board is striving to keep our readers abreast of these recent discoveries.
In “Rise of the Biomarkers – Part 2” (of a four-part series), we cover how we have seen several advances in the diagnosis and evaluation of a number of peripheral nerve disorders, with focus on paranodal analyses and new uses for skin biopsy.
Additional article summaries on biomarkers will be forthcoming in subsequent AANEM publications.
Delmont, E, Manso, C, Querol, L, et al. Autoantibodies to nodal isoforms of neurofascin in chronic inflammatory demyelinating polyneuropathy. Brain 2017 Jul 1; 140(7): 1851-1858
In this multi-center study, the authors identified two possible biomarkers in antineurofascin 186 and 140 antibodies. Through a multinational effort, investigators collected sera from 246 CIDP patients and from 160 patients with non-CIDP neurological inflammatory conditions as well as healthy donor controls. The authors then tested the sera for Ab against known paranodal proteins. The authors describe a small cohort -- five patients (2%) – that tested positive for both antineurofascin 140 and 186. These antibodies were not present in GBS, MS, CMT and control groups.
The anti140/186 group shared clinical characteristics including severity at nadir and marked improvement after therapy. Notably, depletion of the antibodies correlated with improvement.
Comment: This article is interesting for several reasons. Although the antineurofascin 140/186 population was small, this study gives credence to the notion that CIDP is not a homogeneous disease, but term which combines several pathologies which remain to be differentiated and thoroughly described. It breaks ground in that it describes a marker consistent and compatible among a group with similar presentation, and one which could potentially serve as proof of remission.

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