Biomarcadores emergentes en diagnóstico y seguimiento de esclerosis múltiple
DOI:
https://doi.org/10.70577/swdqp234Palabras clave:
Biomarcadores, Diagnóstico, Seguimiento, Esclerosis múltiple.Resumen
La esclerosis múltiple es una enfermedad neuroinflamatoria y neurodegenerativa cuyo diagnóstico y seguimiento continúan representando un desafío clínico. El objetivo de esta revisión fue analizar la evidencia científica disponible sobre los biomarcadores emergentes utilizados en el diagnóstico y seguimiento de la enfermedad, identificando sus aplicaciones clínicas, fortalezas, limitaciones y perspectivas futuras. Se realizó una revisión de la literatura siguiendo las directrices PRISMA 2020 mediante búsquedas en PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect y SpringerLink. Los resultados evidenciaron que el neurofilamento de cadena ligera sérico y la proteína ácida fibrilar glial constituyen los biomarcadores con mayor nivel de evidencia disponible para evaluar de daño neuroaxonal, actividad inflamatoria y progresión clínica. Asimismo, las cadenas ligeras libres kappa y las tecnologías ómicas muestran un potencial creciente para fortalecer el diagnóstico de precisión. Se concluye que la integración de biomarcadores biológicos con neuroimagen e inteligencia artificial permitirá avanzar hacia estrategias de medicina personalizada en la esclerosis múltiple.
Descargas
Referencias
1. Chitnis T, Magliozzi R, Abdelhak A, Kuhle J, Leppert D, Bielekova B. Blood and CSF biomarkers for multiple sclerosis: emerging clinical applications. Lancet Neurol. 2025;24(12):1066-1078. https://doi.org/10.1016/S1474-4422(25)00249-2 DOI: https://doi.org/10.1016/S1474-4422(25)00249-2
2. Di Filippo M, Gaetani L, Centonze D, et al. Fluid biomarkers in multiple sclerosis: from current to future applications. Lancet Reg Health Eur. 2024;44:101009. https://doi.org/10.1016/j.lanepe.2024.101009 DOI: https://doi.org/10.1016/j.lanepe.2024.101009
3. Freedman MS, Gnanapavan S, Booth RA, et al. Guidance for use of neurofilament light chain as a cerebrospinal fluid and blood biomarker in multiple sclerosis management. EBioMedicine. 2024;101:104970. https://doi.org/10.1016/j.ebiom.2024.104970 DOI: https://doi.org/10.1016/j.ebiom.2024.104970
4. Cross AH, Gelfand JM, Thebault S, et al. Emerging cerebrospinal fluid biomarkers of disease activity and progression in multiple sclerosis. JAMA Neurol. 2024;81(4):373-383. https://doi.org/10.1001/jamaneurol.2024.0017 DOI: https://doi.org/10.1001/jamaneurol.2024.0017
5. Benkert P, Maleska Maceski A, Schaedelin S, et al. Serum glial fibrillary acidic protein and neurofilament light chain levels reflect different mechanisms of disease progression under B-cell depleting treatment in multiple sclerosis. Ann Neurol. 2025;97(1):104-115. https://doi.org/10.1002/ana.27096 DOI: https://doi.org/10.1002/ana.27096
6. Meier S, Willemse EAJ, Schaedelin S, et al. Serum glial fibrillary acidic protein compared with neurofilament light chain as a biomarker for disease progression in multiple sclerosis. JAMA Neurol. 2023;80(3):287-297. https://doi.org/10.1001/jamaneurol.2022.5250 DOI: https://doi.org/10.1001/jamaneurol.2022.5250
7. Disanto G, Barro C, Benkert P, et al. Serum neurofilament light: a biomarker of neuronal damage in multiple sclerosis. Ann Neurol. 2017;81(6):857-870. https://doi.org/10.1002/ana.24954 DOI: https://doi.org/10.1002/ana.24954
8. Benkert P, Meier S, Schaedelin S, et al. Serum neurofilament light chain for individual prognostication of disease activity in people with multiple sclerosis. Lancet Neurol. 2022;21(3):246-257. https://doi.org/10.1016/S1474-4422(21)00472-3
9. Hegen H, Berek K, Bsteh G, et al. Kappa free light chain and neurofilament light independently predict early multiple sclerosis disease activity. EBioMedicine. 2023;91:104573. https://doi.org/10.1016/j.ebiom.2023.104573 DOI: https://doi.org/10.1016/j.ebiom.2023.104573
10. Berek K, Bsteh G, Auer M, et al. Kappa-free light chains in cerebrospinal fluid predict early multiple sclerosis disease activity. Neurol Neuroimmunol Neuroinflamm. 2021;8:e1005. https://doi.org/10.1212/NXI.0000000000001005 DOI: https://doi.org/10.1212/NXI.0000000000001005
11. Duell F, Evertsson B, Al Nimer F, et al. Diagnostic accuracy of intrathecal kappa free light chains compared with oligoclonal bands in multiple sclerosis. Neurol Neuroimmunol Neuroinflamm. 2020;7:e775. https://doi.org/10.1212/NXI.0000000000000775 DOI: https://doi.org/10.1212/NXI.0000000000000775
12. Giovannoni G, Popescu V, Wuerfel J, et al. Smouldering multiple sclerosis: the real MS. Ther Adv Neurol Disord. 2022;15:17562864211066751. https://doi.org/10.1177/17562864211066751 DOI: https://doi.org/10.1177/17562864211066751
13. Tintore M, Rovira À, Río J, et al. Defining high, medium and low impact prognostic factors for developing multiple sclerosis. Brain. 2015;138(7):1863-1874. https://doi.org/10.1093/brain/awv105 DOI: https://doi.org/10.1093/brain/awv105
14. Jakimovski D, Bittner S, Zivadinov R, et al. Multiple sclerosis. Lancet. 2023. https://doi.org/10.1016/S0140-6736(23)01473-3 DOI: https://doi.org/10.1016/S0140-6736(23)01473-3
15. Portaccio E, Magyari M, Havrdova EK, et al. Multiple sclerosis: emerging epidemiological trends and redefining the clinical course. Lancet Reg Health Eur. 2024;44:100977. https://doi.org/10.1016/j.lanepe.2024.100977 DOI: https://doi.org/10.1016/j.lanepe.2024.100977
16. Freedman MS, Abdelhak A, Bhutani MK, Freeman J, Gnanapavan S, Hussain S, et al. The role of serum neurofilament light (sNfL) as a biomarker in multiple sclerosis: insights from a systematic review. J Neurol. 2025;272(6):400. https://doi.org/10.1007/s00415-025-13093-1 DOI: https://doi.org/10.1007/s00415-025-13093-1
17. Coker J, Doshi A, Gnanapavan S. The practical uses of serum neurofilament light chain as a biomarker in multiple sclerosis. Mult Scler Relat Disord. 2025;100:106550. https://doi.org/10.1016/j.msard.2025.106550 DOI: https://doi.org/10.1016/j.msard.2025.106550
18. Lin X, Tong J, Wu W, et al. Clinical applications and diagnostic research of GFAP and NfL in multiple sclerosis and neuromyelitis optica spectrum disorder: a meta-analysis. BMC Immunol. 2025;26:55. https://doi.org/10.1186/s12865-025-00735-2 DOI: https://doi.org/10.1186/s12865-025-00735-2
19. Hani A, et al. The role of neurofilament light (NfL) and glial fibrillary acidic protein (GFAP) in multiple sclerosis and AQP4-NMOSD: advancing clinical applications. eNeurologicalSci. 2025;38:100550. https://doi.org/10.1016/j.ensci.2025.100550 DOI: https://doi.org/10.1016/j.ensci.2025.100550
20. Abdelhak A, Huss A, Kassubek J, Tumani H, Otto M. Serum glial fibrillary acidic protein as a biomarker of disease severity and progression in multiple sclerosis. Neurology. 2024. https://doi.org/10.1212/WNL.0000000000209844 DOI: https://doi.org/10.1212/WNL.0000000000209844
21. Khalil M, Pirpamer L, Hofer E, Voortman MM, Barro C, Leppert D, et al. Serum neurofilament light levels in normal aging and their association with morphologic brain changes. Nat Commun. 2020;11:812. https://doi.org/10.1038/s41467-020-14612-6 DOI: https://doi.org/10.1038/s41467-020-14612-6
22. Bittner S, Steffen F, Uphaus T, et al. Clinical implications of serum neurofilament light chain in multiple sclerosis. Nat Rev Neurol. 2024. https://doi.org/10.1038/s41582-024-00952-8
23. Hegen H, Bsteh G, Berger T. Biomarkers for treatment response in multiple sclerosis. Nat Rev Neurol. 2023. https://doi.org/10.1038/s41582-023-00841-4
Descargas
Publicado
Número
Sección
Licencia
Derechos de autor 2026 Nayely Micaela Yaguana Retete, Jimmy Fernando Yaguana Torres, Victor José Barrera Avendaño, George William Rodríguez Correa, Dana Milena Mosquera Calderón (Autor/a)
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.
