Robert Weissert

Frontiers in Neurology

Weissert, Robert

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Editorial: Insights in multiple sclerosis and neuroimmunology: 2021

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TYPE EditorialPUBLISHED 20 July 2023DOI 10.3389/fneur.2023.1251877OPEN ACCESSEDITED AND REVIEWED BYMarcello Moccia,University of Naples Federico II, Italy*CORRESPONDENCERobert Weissertrobert.weissert@ukr.deRECEIVED 02 July 2023ACCEPTED 05 July 2023PUBLISHED 20 July 2023CITATIONWeissert R (2023) Editorial: Insights in multiplesclerosis and neuroimmunology: 2021.Front. Neurol. 14:1251877.doi: 10.3389/fneur.2023.1251877COPYRIGHT© 2023 Weissert. This is an open-access articledistributed under the terms of the CreativeCommons Attribution License (CC BY). The use,distribution or reproduction in other forums ispermitted, provided the original author(s) andthe copyright owner(s) are credited and thatthe original publication in this journal is cited, inaccordance with accepted academic practice.No use, distribution or reproduction ispermitted which does not comply with theseterms.Editorial: Insights in multiplesclerosis and neuroimmunology:2021Robert Weissert*Department of Neurology, University of Regensburg, Regensburg, GermanyKEYWORDSautoimmunity, central nervous system, multiple sclerosis, autoimmune encephalitis,biomarkers, clinical outcomesEditorial on the Research TopicInsights in multiple sclerosis and neuroimmunology: 2021A total of 19 articles are published in the Frontiers Research Topic “Insights in multiplesclerosis and neuroimmunology 2021.” These cover a wide aspect of multiple sclerosis (MS)-related themes as well as themes in autoimmune encephalitis.There is a need for consensus criteria about the identification of certain types of MS.Meca-Lallana et al. show in their article “Consensus on early detection of disease progressionin patients with multiple sclerosis” that such consensus statements could help clinicians tofind early in the disease course patients with secondary progressive MS (SPMS). Such anearly identification is important to perform adequate therapeutic management. Standardizedclinical assessments are meaningful in MS care. In the article “Making every step count:minute-by-minute characterization of step counts augments remote activity monitoring inpeople with multiple sclerosis,” Block et al. used a model to predict disease progression overthe longer term (>2 years) based on obtained measurements. These findings will be usedto develop further descriptive metrics for activity. In their article “Current status and futureopportunities in modeling clinical characteristics of multiple sclerosis,” Liu et al. suggest thatthere is a strong need to develop validated models of MS clinical outcomes by using cellularor/and molecular biomarkers. In the article titled “Models of care in multiple sclerosis: asurvey of Canadian health providers,” Marrie, Donkers et al. claim that the ideal MS serviceis multidisciplinary in nature, ideally integrated, and with prompt access to care.The myxovirus resistance protein A (MxA) has been long used as a marker forexogenous interferon-beta efficacy in MS treatment. Coerver et al. show in the article“The association between blood MxA mRNA and long-term disease activity in earlymultiple sclerosis” that MxA mRNA is expressed in inflammatory pathology in MSthat is dependent on the endogenous type-1 interferon system and that this mightbe a prognostic biomarker for long-term inflammatory disease activity in MS. In thearticle “Genetic risk variants for multiple sclerosis are linked to differences in alternativepre-mRNA splicing” by Putscher et al., the authors show that genetic variants fromMS risk loci affect pre-mRNA splicing. Amoriello et al. investigated soluble HLA-G(sHLA-G) levels in MS in the article “Investigating serum sHLA-G cooperation with MRIactivity and disease-modifying treatment outcome in relapsing-remitting multiple sclerosis.”Frontiers inNeurology 01 frontiersin.orgWeissert 10.3389/fneur.2023.1251877They found that the HLA-G genotype strongly influencessHLA-G levels. Autoantibodies are of importance in variousneuroimmunological disorders, and their role and mechanismof action are partly undefined. In the article “Peptidylargininedeiminase 2 autoantibodies are linked to less severe disease inmultiple sclerosis and post-treatment Lyme disease,” Kim et al. makethe case that anti-peptidylarginine deiminase 2 (PAD2) antibodiesmay attenuate inflammation. This effect is observable in tissueswith high expression of PAD2. The role of hemolysis was analyzedin the article “Peripheral hemolysis in relation to iron rim presenceand brain volume in multiple sclerosis” by Krajnc et al. The authorsfound an influence of hemolysis on the brain volume but not on thepresence of iron rim lesions in progressiveMS. Investigations aboutmetabolomics in neuroimmunological disorders is of increasinginterest. In their study “Metabolomics of cerebrospinal fluid inmultiple sclerosis compared with healthy controls: a pilot study,”Židó et al. investigated cerebrospinal fluid (CSF) from MS patientscompared to controls regarding metabolomic profiles. They founddifferences in amino and fatty acids in the CSF of newly diagnosedpatients withMS in comparison with controls. The most significantchanges were seen in levels of arginine, histidine, and palmiticacid. They concluded that such a metabolomic profile may predictinflammatory disease activity in MS. In the article “Effects ofvascular comorbidity on cognition in multiple sclerosis are partiallymediated by changes in brain structure,” Marrie, Patel et al. showedthat vascular comorbidity leads to changes in brain macrostructureand microstructure. In addition, this is associated with lowercognitive function in patients with MS.In “Bridging therapies with injectable immunomodulatory drugsin the management of multiple sclerosis: a Delphi survey of anItalian expert panel of neurologists,” Marfia et al. suggest thatthe value of bridging therapy with injectable immunomodulatorydrugs in MS disease conditions is underscored. The articlefocuses on patients with MS who plan to become pregnantand patients with MS at risk for cancer recurrence. Ozanimodis a selective sphingosine-1-phosphate (S1P)-receptor 1 (S1P1)and S1P5 modulator used for the treatment of active forms ofrelapsing-remitting MS (RRMS). Ziemssen et al. present their real-world and long-term study “OzEAN study to collect real-worldevidence of persistent use, effectiveness, and safety of ozanimodover 5 years in patients with relapsing-remitting multiple sclerosisin Germany.” The results of this study will add to the safetyprofile and efficacy profile of ozanimod in the treatment of RRMS.In the study “Safety, adherence and persistence in a real-worldcohort of German MS patients newly treated with ocrelizumab:first insights from the CONFIDENCE study,” Weber et al. describethe safety profile of ocrelizumab in the CONFIDENCE real-world MS population study. The findings were consistent with thefindings in pivotal clinical trials for the anti-CD20 B cell-depletingantibody ocrelizumab used for the treatment of patients with RRMSand patients with primary progressive MS (PPMS). Importantly,high treatment persistence and adherence were seen in this real-world MS population study. Fathi et al. suggested in their article,“Dynamic changes in kynurenine pathway metabolites in multiplesclerosis: a systematic review,” that quinolinic acid is a possibleplayer in the pathogenesis of MS. This conclusion is mainly basedon the finding that quinolinic acid levels in CSF were higher inpatients with MS than in healthy controls. The value of diseasemodels induced in mice and rats on certain novel MS therapeuticapproaches is outlined by Jayaraman and Jayaraman in their article“Impact of histone modifier-induced protection against autoimmuneencephalomyelitis on multiple sclerosis treatment” about histonedeacetylase (HDAC) inhibitors. HDAC inhibitors such as valproicacid and hydroxamates as well as others are possible candidates forfuture treatment of MS.It has been shown that in paraneoplastic forms of autoimmuneencephalitis, the removal of the associated cancer entity is ofprimary importance in long-term disease outcomes. For teratoma,Zhang et al. show in their article “Long-term prognosis ofpatients with anti-N-methyl-D-aspartate receptor encephalitis whounderwent teratoma removal: an observational study” that earlydetection and removal of teratoma resulted in a favorable long-term prognosis in patients with anti-NMDAR encephalitis. Casestudies can be of importance for defining potential new diseaseentities and for the description of rare disease variants. In the casestudy “Acute cerebellitis associated with anti-homer 3 antibodies:a rare case report and literature review” by Miao et al., theauthors underscore the need for immune-mediated causes tobe considered in acute cerebellitis. Importantly, immunotherapycan contribute to the improvement of cerebellar syndrome.Neuropsychological assessment is important in phenotypingand care of patients with neuroimmunological disorders andespecially autoimmune encephalitis. In the article by Chan etal., “Cognitive and mood profiles among patients with stiff personsyndrome spectrum disorders,” it is clarified that neuropsychologicaltesting in stiff person syndrome should include testing of verballearning and recall, phonemic verbal fluency, attention, andprocessing speed.In conclusion, the Research Topic “Insights in multiple sclerosisand neuroimmunology 2021” gives novel insight into currentresearch themes on MS and autoimmune encephalitis.Author contributionsRW outlined and wrote the Editorial.Conflict of interestThe author declares that the research was conducted in theabsence of any commercial or financial relationships that could beconstrued as a potential conflict of interest.Publisher’s noteAll claims expressed in this article are solely thoseof the authors and do not necessarily represent those oftheir affiliated organizations, or those of the publisher,the editors and the reviewers. Any product that may beevaluated in this article, or claim that may be made byits manufacturer, is not guaranteed or endorsed by thepublisher.Frontiers inNeurology 02 frontiersin.org

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Editorial: Insights in multiple sclerosis and neuroimmunology: 2021

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