Researchers at the Montreal Neurological Institute and other centers in Canada performed proteomics screening of CSF samples collected from 19 children at presentation of acquired inflammatory CNS demyelinating syndromes. Children were followed prospectively and 8 developed MS-defining recurrent disease activity (acquired CNS demyelinating syndrome [ADS]); 11 had no recurrent disease (ADS-monophasic) over a median period of 4.88 years (range, 2.52-6.12 years). Mass spectroscopy, peptide profiling, and quantitative immunoblotting were used to identify CSF proteins that might discriminate MS from monophasic demyelination.

Major compact myelin membrane proteins typically implicated in MS were not detected. Instead, multiple molecules that localize to the node of Ranvier and the surrounding axoglial apparatus membrane were increased by 10.2-fold in children subsequently diagnosed with MS. The CSF proteome signature obtained at the presentation of CNS inflammation may be predictive of subsequent MS diagnosis. [1]

COMMENT. In the same issue of the Annals, investigators from Japan report on the use of CSF proteomic pattern analysis to discriminate MS-related disorders in 107 adult patients [2]. An editorial [3] comments that CSF proteomics is a promising window and biomarker for demyelinating disorders.