| Axonal loss in Multiple sclerosis (MS) is increasingly recognised as an important correlate of disease progression. We observed a relation between levels of axon-specific CSF markers, such as N-acetylaspartate, and atrophy as a magnetic resonance imaging (MRI) marker for axonal loss. Therefore, we hypothesise that axonal loss results in altered levels of biomarkers in body fluids. These biomarkers in body fluids will be very useful for monitoring and predicting disease progression. To date, few such markers are available. This could be due to the lack of knowledge of mechanisms of neurodegeneration in MS and the possible involvement of several mechanisms simultaneously. Therefore, for complex diseases such as MS, the old paradigm of a single causal factor and diagnosis based on a single marker is no longer valid. It is becoming increasingly clear that novel discovery-based technologies, such as proteomics, that profile large numbers of peptides and proteins simultaneously hold great potential for finding panels of diagnostic and prognostic biomarkers. Therefore, the aim of the present study is to develop candidate biomarkers for disease progression and axonal loss in MS based on protein and peptide patterns in body fluids obtained by proteomics-tools. We will perform this study in three steps using two complementary mass spectrometry-based proteomics approaches: i. Comparison of protein patterns in serum and CSF of MS patients between relapse-onset MS patients and controls using high-throughput peptide/protein profiling. ii. Comparison of protein patterns in serum and CSF of MS patients between relapse-onset MS patients and controls using in-depth peptide/protein profiling. iii. Correlation of obtained profiles to known surrogate markers for axonal loss, such as CSF markers of axonal loss, clinical scores and MRI markers for atrophy. The results will lead to candidate biomarkers to be validated in future studies and new therapeutic lead points for axonal damage and progression in MS. Lastly, the data generated will lead to new hypotheses on the underlying disease processes of axonal loss in MS. |