b'Medicine & ResearchRX UpdateSShheeddddiinnggLLiigghhttoonnMMSSMonitoring Neurolament Light Chain Biomarkersand the Progression of DiseaseBy Ellen Whipple, Pharm.D. and Brittany Brooks, BS Chemistry, Pharm.D. Candidate 2022Thecurrentfundamentalgoalsinthe this neurolament type. Light chains weretreatment of MS are to decrease relapses, slow discovered to be a biomarker of current andthe progression of disease, and manage MS future disease activity because it is the mostsymptomswhileimprovingorpreserving abundant of the three neurolaments found. quality of life. If doctors can identify patients These chains can detect spinal cord pathologywith more aggressive MS early on, there may be that may not show up on a magnetic resonancea possibility to alter the trajectory of the disease, imaging of the brain, show a correlation withpreventing or delaying the accumulation of the development of gadolinium-enhanceddisability with aggressive treatment. According lesions,andindicateifdisease-modifyingto Dr. Ben Thrower, medical director at the MS therapy is effective. During incidence ofInstitute at Shepherd Center, While there are relapse, a patients levels of neurolamentcurrently no accepted biomarkers to indicate light chains are up to 10 times higher whendisease severity and inform choice of therapy, compared to neurolament light chain levelsserum neurolament chain levels are emerging during remission. Dr. Thrower explained thatas important biomarkers in multiple sclerosis.elevated levels of the neurolament light chainsNeurolament chains have been correlated to poorer neurologicNeurolament chains are neuronal-specic function including decreased cognitiveproteins that are major structural components performance, manual dexterity, and walkingof the axons. As damage to the myelinated speed.axon occurs, the neurofilament chains are ELISA and Simoareleased into the cerebrospinal uid and blood Themethodsmostcommonlyusedforserum, or plasma. There are three dierent measuring neurolament light chains are theclassicatons of neurolament chains: light, high-sensitivity enzyme-linked immunoassaymedium, and heavy chain. Research is (ELISA) and the single-molecule array (Simoa).continually being conducted on the eect of ELISAisappropriateformeasuringwithheavy neurolament chains and in the future, samples taken from cerebrospinal uid whilethese neurolament heavy chains could give Simoa is used for samples from serum ormore insight into the progression of the plasma in the blood. The Simoa has moredisease. Medium chains have no clinical role analytical sensitivity compared with ELISAin MS treatment at this time but with further even though neurolament light chains areresearch, there may be benet in analyzing 10 times more concentrated in cerebrospinalmsfocusmagazine.org 56'