WATCH TIME: 4 minutes | Captions are auto-generated and may contain errors.
“I would definitely recommend, as I mentioned in the talk, not to rely on only one biomarker as an outcome parameter in remyelination clinical trials. Let’s leverage the different tools we now have. Let’s find out whether our remyelinating drug really induces functional electrophysiological recovery.”
Multiple sclerosis (MS) is a chronic autoimmune disease that can lead to significant neurodegeneration, particularly in its progressive form, for which effective treatments remain limited. One promising development has been the use of sensitive neurofilament light chain (NfL) assays to help predict disease activity and progression. Although NfL offers an additional readout for clinical trials, it is not specific to MS, as levels can be elevated in other neurodegenerative disorders. Factors such as age, body mass index, and blood volume can further influence results, and considerable overlap exists between serum NfL levels in patients with MS and healthy controls, underscoring the need for additional or complementary biomarkers.
Beyond NfL, a range of blood and cerebrospinal fluid (CSF) biomarkers related to axonal damage, neuronal injury, glial dysfunction, demyelination, and inflammation have been explored for their potential in MS. However, these markers can share similar limitations to NfL when used in isolation. To address this, researchers are increasingly turning to bioinformatic and multiomic approaches that integrate cellular studies, microRNAs, extracellular vesicles, metabolomics, and microbiome analyses. A comprehensive biomarker panel combining these measures may improve diagnostic and prognostic accuracy, highlighting the importance of continued research using advanced tools.1
At the 2025 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, held May 28-31, 2025, in Phoenix, Ahmed Abdelhak, MD, discussed the role of emerging serum and imaging biomarkers in assessing remyelination during clinical trials during a session.2 In an interview with NeurologyLive® at the meeting, Abdelhak, assistant professor of neurology at the University of California, San Francisco, emphasized the complementary nature of fluid and MRI-based markers. Proteomic signatures, he noted, may shed light on why patients respond differently to treatments, opening the door to more personalized remyelination strategies. Abdelhak also underscored the need for multimodal approaches to more effectively evaluate treatment effects and accelerate translation into clinical practice.
Click here for more coverage of CMSC 2025.