Biomarkers In Autoimmune Diseases Of The Central Nervous System

Autoimmune diseases of the central nervous system (CNS) are a group of complex and disabling disorders characterized by the immune system mistakenly attacking the CNS. During the last 2 decades, we have witnessed a rapidly evolving spectrum of CNS autoimmune diseases, which has become a research hotspot in neurology. These include CNS inflammatory demyelinating diseases such as multiple sclerosis and neuromyelitis optical spectrum disorders, paraneoplastic, and other autoimmune encephalomyelitis and CNS involvement in systemic autoimmune diseases. Recently, although remarkable discoveries have accumulated more understanding of the autoimmune basis behind the physiopathologic mechanism, the exact pathogenic processes are still unclear. Patients may present with a variety of manifestations, posing a great challenge to diagnosis and management. The determination of biomarkers plays a significant role in CNS autoimmune diseases. Biomarkers can reflect the presence, nature, and intensity of certain immune responses triggered by both genetic and environmental processes, and bear great importance in guiding clinical diagnosis, estimating disease risk or prognosis, evaluating disease severity, and monitoring progression or response to therapy. For instance, the detection of disease-specific antibodies can contribute to the accurate diagnosis and precise treatment. Moreover, identifying the diverse biomarkers could further help to achieve the ultimate goal of personalized medicine.

Neuroinflammation is a burgeoning area of interest in academia and biopharma, with a broadly acknowledged role in many central nervous system (CNS) disorders. However, there is little agreement on the pathophysiological mechanisms that underlie the manifestations of neuroinflammation in the CNS compartment and how neuroinflammation operates as a driver and also as a consequence of disease in the brain. Moreover, another unclear area is how to translate increased understanding of the mechanisms that underlie neuroinflammation and its manifestations in the CNS to therapeutics. To address these gaps in understanding mechanisms and how to translate that understanding into therapeutics, the Forum on Neuroscience and Nervous System Disorders of the National Academies of Sciences, Engineering, and Medicine convened a workshop on March 20-21, 2017, bringing together key leaders in the field from industry, academia, and governmental agencies to explore the role and mechanisms of neuroinflammation in a variety of CNS diseases. The workshop also considered strategies to advance the identification and validation of biomarkers of neuroinflammation that could accelerate development of therapies, bringing much-needed treatments to patients with disorders ranging from neuroinflammatory diseases such as multiple sclerosis (MS) to neuropsychiatric disorders such as depression. This publication summarizes the presentations and discussions from the workshop.

Every year, an estimated 1.7 million Americans sustain brain injury. Long-term disabilities impact nearly half of moderate brain injury survivors and nearly 50,000 of these cases result in death. Over the last decade, the field of neurotrauma has witnessed significant advances, especially at the molecular, cellular, and behavioral levels. This progress is largely due to the introduction of novel techniques, as well as the development of new animal models of central nervous system (CNS) injury. Brain Neurotrauma: Molecular, Neuropsychological, and Rehabilitation Aspects provides a comprehensive and up-to-date account on the latest developments in the area of neurotrauma, including brain injury pathophysiology, biomarker research, experimental models of CNS injury, diagnostic methods, and neurotherapeutic interventions as well as neurorehabilitation strategies in the field of neurotraum research. The book includes several sections on neurotrauma mechanisms, biomarker discovery, neurocognitive/neurobehavioral deficits, and neurorehabilitation and treatment approaches. In addition, a section is devoted to models of mild CNS injury, including blast and sport-related injuries. This book, with its diverse coherent content, is a valuable and comprehensive reference for individuals interested in the diverse and heterogeneous aspects of CNS pathology and/or rehabilitation needs.

Mechanisms of Disease Pathogenesis in Multiple Sclerosis summarizes our current understanding on MS and its clinical features and monitoring with available biomarkers, focusing on mechanisms that drive disease pathogenesis and their control by genetic, environmental factors and novel therapies for disease management. The book is written for neurologists, neuroimmunologists and clinical, translational and basic researchers interested in mechanisms of neurodegeneration. Multiple Sclerosis (MS) is an autoimmune disease which targets the central nervous system (CNS). It is the most common cause of non-traumatic neurological disability in young adults with a prevalence of 1 in 1000 and increasing, hence the importance of this book. Summarizes our current understanding of Multiple Sclerosis Discusses clinical features and available biomarker monitoring Focuses on mechanisms that drive disease pathogenesis

Due to injuries sustained in sports and in combat, interest in traumatic brain injury (TBI) has never been greater. This book will fulfill a gap in understanding of what is occurring in the brain following injury that can subsequently be detected in biological fluids and imaging.

Neurotrauma: A Comprehensive Textbook on Traumatic Brain Injury and Spinal Cord Injury aims to bring together the latest clinical practice and research in the filed of two forms of trauma to the central nervous system: namely traumatic brain injury (TBI) and spinal cord injury (SCI). Nationally, more 1.9 million Americans sustain a traumatic brain injury annually. In parallel, there are an estimate of 12,000 new cases of SCI in the United States annually. In addition, approximately 1.2 million people live with paralysis due to SCI. In recent years, dramatic advancements in the field have resulted in much improved outcomes for patients and higher standards of care. This volume details the latest research and clinical practice in the treatment of neurotrauma, in a comprehensive but easy-to-follow format. Neurotrauma is a valuable resource for any clinician involved in caring for TBI and SCI patients, clinical research professionals, researchers, medical and graduate students, and nurse specialists.

Autoimmune Neurology presents the latest information on autoimmune neurologic disease, the immune response to the body where organs run wild, causing the immune system to attack itself. Autoimmunity is a main element in numerous nervous system diseases and can target any structure within the central or peripheral nervous system. Over the past 20 years, significant advances in our understanding of the pathophysiology of autoimmune disorders, including the use of biomarkers has led to new diagnosis and treatment options. Neurologic conditions associated with autoimmune reactions include dementia, neuromuscular disease, epilepsy, sleep disorders, diabetes, and other common neurologic disorders and disease. This current tutorial-reference will be a must-have title for clinical neurologists, research neurologists, neuroscientists, and any medical professional working with autoimmune disease and disorders. Includes comprehensive coverage of autoimmune neurology Details the latest techniques for the study, diagnosis, and treatment of diseases and disorders, including dementia, neuromuscular disease, epilepsy, and sleep disorders Presents a focused reference for clinical practitioners and the clinical neurology and neurology research communities