In this study from the US, the researchers investigated if fetuin-A is an indicator of disease activity. Fetuin-A is a serum protein secreted mainly from the liver that functions in a wide variety of physiological and pathological processed. It has recently been identified as a potential biomarker in MS, with many functions, including a role in immune pathways.
The researchers found that fetuin-A levels were reduced in CSF one year post treatment with natalizumab. Interestingly, they found that 69% of natalizumab-treated patients overall had decreased fetuin-A levels, which correlates with the known response rate to natalizumab treatment. Fetuin-A was increased in demyelinating lesions and in grey matter within MS brain tissue. In EAE, they found fetuin-A was elevated in degenerating neurons around demyelinating lesions. Also, fetuin-A deficient mice demonstrated delayed onset and reduced severity of EAE symptoms.
Therefore, this study shows that CSF fetuin-A is a biomarker of disease activity and natalizumab response in MS. It raises the possibility that fetuin-A may play a role in the disease process but this needs to be investigated further.