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Developing Novel Diagnostic Strategies to Define Pathologic Features in MS and TM Patients

An important research endeavor in many disease entities has been the development of better and novel diagnostic strategies in the form of non-invasive imaging, biomarkers and neuronal markers of injury. These markers are critical as objective measures of outcome in designing clinical trials.

Development of novel imaging strategies:

To better define the pathology and subtypes of transverse myelitis (TM) and multiple sclerosis (MS), we must develop novel imaging strategies for patients. Although conventional MRI approaches effectively define abnormal regions within the nervous system, they do not precisely define what that abnormality is. Emerging technologies allow a more precise understanding of pathology in the nervous system and can identify appropriate therapeutic interventions in the phase during which those interventions are likely to be helpful.

Proteomics to develop biomarkers:

The past decade has seen much research focused on gene expression arrays that have identified several novel transcripts in MS brain tissue. Proteomics is a relatively newer field that holds significant promise for identifying individual proteins or patterns of proteins that are involved in MS.

Johns Hopkins Medicine has a large proteomics facility that includes several mass spectroscopy units, gas chromatography, HPLC, and a dedicated bioinformatics unit.

This facility has been further coupled with laser capture microscopy and thus has the ability to work with complex biological material to identify unique proteins, peptides, lipids, or carbohydrate moieties expressed in pathological tissues and fluids.

Additionally, the Johns Hopkins Medicine Multiple Sclerosis Center has acquired a Ciphergen proteomics machine (SELDI mass spectroscopy) that is capable of screening large numbers of clinical serum and CSF MS samples to screen for patterns of aberrant protein expression. This project has already been initiated and thus will be operative during years 1-5 of the project.

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