Biomarkers for assessing subjects with multiple sclerosis
Disclosed herein are methods in which an individual with multiple sclerosis (MS) can be classified into one of six subject groups, each subject group predictive for the patient's responsiveness to an interferon-β (IFN-β) therapy. The individual with MS can be classified according to the individual's serum marker levels, e.g., at baseline or following treatment with therapy. Depending on the classification, the individual with MS can be treated with standard therapies (e.g. IFN-β) or one or more alternative therapies with or without IFN-β.
1. A method for treating a subject with multiple sclerosis comprising:
performing or having performed at least one protein biomarker detection assay on a sample from the subject to determine the expression level of a panel of biomarkers indicating biomarker expression levels in the sample from the subject, the panel of biomarkers comprising IL-1β, IL-8, CCL2/MCP1, IL-1RA, CXCL1/Groα, IL-6, G-CSF, CD40L, IL-17F, IFN-β, and CXCL10/IP10; and
classifying or having classified the subject into at least one of group 1, group 2, group 3, group 4, group 5, and group 6 based on the expression level of the panel of biomarkers as compared to a control profile of biomarker levels in patients with multiple sclerosis;
wherein group 1 is characterized by the sample having higher expression level of only CD40L as compared to the control profile;
wherein group 2 is characterized by the sample having lower or not significantly different expression levels of all biomarkers in the panel of biomarkers as compared to the control profile;
wherein group 3 is characterized by the sample having higher expression levels of IL-8, CXCL1/Groα, IL-1β, IL-1RA, and CCL2/MCP1 in the panel of biomarkers as compared to the control profile;
wherein group 4 is characterized by the sample having higher expression levels of G-CSF and CD40L in the panel of biomarkers as compared to the control profile;
wherein group 5 is characterized by the sample having higher expression levels of CSCL10/IP10 and IL-6 in the panel of biomarkers as compared to the control profile; and
wherein group 6 is characterized by the sample having higher expression levels of IFN-β and IL-17F in the panel of biomarkers as compared to the control profile, and
treating the subject based on the subject's classification into groups 1 to 6
wherein when the subject is classified in group 1 or group 5, the subject is treated with IFN-β alone or in combination with at least one selected from the group consisting of glatiramer acetate, natalizumab, dimethyl fumarate, fingolimod, statins, methylprednisolone, methotrexate, cladribine, cyclophosphamide, anti-IFN γ antibody, CTLA4-Ig, anti-CD20 antibody, anti-CD52 antibody, IL-17 inhibitor, IL-23 inhibitor, and bone marrow stem cell transplantation therapy;
wherein when the subject is classified in group 3 or group 6, the subject is treated with one of glatiramer acetate, anti-VLA4, dimethyl fumarate, or teriflunomide alone or in combination with at least one selected from the group consisting of fingolimod, statins, methylprednisolone, methotrexate, cladribine, cyclophosphamide, anti-IFN γ antibody, CTLA4-Ig, anti-CD20 antibody, anti-CD52 antibody, IL-17 inhibitor, IL-23 inhibitor, and bone marrow stem cell transplantation therapy; and
wherein when the subject is classified in group 2 or group 4, the subject is treated either with a combination of IFN-β and one of glatiramer acetate, anti-VLA4, dimethyl fumarate, or teriflunomide, or with a combination of IFN-β and one of fingolimod, a statin, methylprednisolone, methotrexate, cladribine, cyclophosphamide, anti-IFN γ antibody, CTLA4-Ig, anti-CD20 antibody, anti-CD52 antibody, IL-17 inhibitor, IL-23 inhibitor, and bone marrow stem cell transplantation therapy.
2. The method of claim 1 , wherein the at least one biomarker detection assay is a multiplex protein assay.
3. The method of claim 1 , wherein the panel of biomarkers further comprises LIF, IFN-α, MIP1α, IL-10, IL-17A, sTRAIL, PAI-1, CXCL5, HGF, NGF, IL-7, MIG/CXCL9, and VCAM.
4. The method of claim 1 , wherein the panel of biomarkers comprises eleven biomarkers.
5. The method of claim 1 , wherein the sample comprises protein from blood of the subject.
6. The method of claim 1 , wherein the sample comprises protein from blood of the subject, the blood of the subject is obtained prior to treatment of the subject with IFN-β.
7. The method of claim 1 , wherein the sample comprises protein from blood of the subject, the blood of the subject is obtained 3 months after beginning treatment of the subject with IFN-β.
8. A method for treating a subject with multiple sclerosis comprising:
wherein the subject's expression levels of IL-1β, IL-8, CCL2/MCP1, IL-1RA, CXCL1/Groα, IL-6, G-CSF, CD40L, IL-17F, IFN-β, and CXCL10/IP10 in a sample from the subject have been determined; and
classifying or having classified the subject into at least one of group 1, group 2, group 3, group 4, group 5, and group 6 based on the expression level of the panel of biomarkers as compared to a control profile of biomarker levels in patients with multiple sclerosis;
wherein group 1 is characterized by the sample having higher expression level of only CD40L as compared to the control profile;
wherein group 2 is characterized by the sample having lower or not significantly different expression levels of all biomarkers in the panel of biomarkers as compared to the control profile;
wherein group 3 is characterized by the sample having higher expression levels of IL-8, CXCL1/Groα, IL-1β, IL-1RA, and CCL2/MCP1 in the panel of biomarkers as compared to the control profile;
wherein group 4 is characterized by the sample having higher expression levels of G-CSF and CD40L in the panel of biomarkers as compared to the control profile;
wherein group 5 is characterized by the sample having higher expression levels of CSCL10/IP10 and IL-6 in the panel of biomarkers as compared to the control profile; and
wherein group 6 is characterized by the sample having higher expression levels of IFN-β and IL-17F in the panel of biomarkers as compared to the control profile, and
treating the subject based on the subject's classification into groups 1 to 6
wherein when the subject is classified in group 1 or group 5, the subject is treated with IFN-β alone or in combination with at least one selected from the group consisting of glatiramer acetate, natalizumab, dimethyl fumarate, fingolimod, statins, methylprednisolone, methotrexate, cladribine, cyclophosphamide, anti-IFN γ antibody, CTLA4-Ig, anti-CD20 antibody, anti-CD52 antibody, IL-17 inhibitor, IL-23 inhibitor, and bone marrow stem cell transplantation therapy;
wherein when the subject is classified in group 3 or group 6, the subject is treated with one of glatiramer acetate, anti-VLA4, dimethyl fumarate, or teriflunomide alone or in combination with at least one selected from the group consisting of fingolimod, statins, methylprednisolone, methotrexate, cladribine, cyclophosphamide, anti-IFN γ antibody, CTLA4-Ig, anti-CD20 antibody, anti-CD52 antibody, IL-17 inhibitor, IL-23 inhibitor, and bone marrow stem cell transplantation therapy; and
wherein when the subject is classified in group 2 or group 4, the subject is treated either with a combination of IFN-β and one of glatiramer acetate, anti-VLA4, dimethyl fumarate, or teriflunomide, or with a combination of IFN-β and one of fingolimod, a statin, methylprednisolone, methotrexate, cladribine, cyclophosphamide, anti-IFN γ antibody, CTLA4-Ig, anti-CD20 antibody, anti-CD52 antibody, IL-17 inhibitor, IL-23 inhibitor, and bone marrow stem cell transplantation therapy.