2023 Fiscal Year Final Research Report
Investigation of immunopathogenic diversity contributing to clinical heterogeneity in multiple sclerosis
| Project/Area Number |
19K16923
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| Research Category |
Grant-in-Aid for Early-Career Scientists
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 51030:Pathophysiologic neuroscience-related
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| Research Institution | Kyoto Prefectural University of Medicine |
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Principal Investigator |
Fujii Chihiro 京都府立医科大学, 医学(系)研究科(研究院), 客員講師 (00516065)
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| Project Period (FY) |
2019-04-01 – 2024-03-31
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| Keywords | multiple sclerosis / clinical diversity / immunological diversity / biomarker / disease modifying drugs / red flags / precision medicine |
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| Outline of Final Research Achievements |
In this study, we investigated the association between differences in the response to disease-modifying drugs (DMD), and various clinical features and their underlying immunopathogenic diversity in patients with multiple sclerosis (MS). Our results showed that the efficacy of MS-DMD would vary depending on the presence or absence of typical clinical findings of MS, such as ring-like or nodular contrast-enhancing lesions in brain MRI and negativity for serum autoantibodies. We also found that the diversity of clinical findings may be due to immunological differences that can be categorized by cytokine/chemokine profiles in cerebrospinal fluid. The elucidated association between clinical findings, immunological features and the efficacy of MS-DMD may allow us to select more effective and suitable drugs for the treatment of individuals of MS .Our findings would be an important step for precision medicine of MS.
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| Free Research Field |
神経内科
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| Academic Significance and Societal Importance of the Research Achievements |
希少難病である神経免疫疾患、多発性硬化症の治療については、近年複数の治療薬が登場し治療予後も大きく改善している一方、個々の患者さんの臨床的特徴、免疫学的特徴に応じた治療の個別化は進んでいない。
本研究では、多発性硬化症患者さんが呈する様々な臨床所見の背景には免疫学的な相違がある可能性を、髄液のサイトカインプロファイル解析から見出した。また、臨床所見の違いによって、MS治療薬の有効性が異なる可能性を示した。臨床的特徴と免疫学的特徴、治療薬の有効性との関連性が明らかになったことで、今後は臨床的・免疫学的特徴から個々の患者さんにより有効性の高い適切な治療薬を選択できることが期待される。
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