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BEHANDLING-God og treffsikker diagnostikk, behandling og rehabilitering

Inno-Indigo: Initiative for development of biomarkers in immune neuropathies

Alternative title: Biomarkører ved kronisk betennelse i perifere nerver

Awarded: NOK 1.7 mill.

Chronic inflammatory polyneuropathy (CIDP) is rare, but may be severe since it causes pareses in arms and legs. The diagnosis, treatment and evaluation of prognosis can be challenging. Therefore, we need biomarkers for helping the clinicians for better diagnostics, treatment and follow up. This is a collaboration with India and Germany where we have identified cohorts of CIDP patients in the three countries and compared clinical and paraclinical signs, treatment options and long term follow up. Further, we have collected serum, blood cells and stool specimens for further immunodiagnostics. We have established various techniches for biomarkers that will be of great value for our understanding of the pathogenesis of the disease, as well as for use in treatment and prognostic evaluations.

Cohorts of CIDP patients have been indentified in Germany, India and Norway. Sera, blood cells and stool specimens have been collected. We have 3 aims: 1. Better diagnostics: - Serum antibodies (gangliosides/MAG/paraneoplastic) are in routine diagnostics. New antibodes such as neurofacin and contactin are planned for diagnostic tests in 2020. - Ultrasound technique performed on peripheral nerves has been established in Germany, India and Norway. - Better cerebrospinal fluid examination will be performed with a new capillary electrophoresis method (Peggy Sue) established in Bergen, Norway in 2019. 2. Better folow up: -Serum marker for neuronal death (neurofilament light chain) has been established in Bergen, Norway (Simoa) in 2019. 3. Outline probably cofactors for etiology: -Analysis of gut microbiome is currently running in Køln, Germany.

Chronic inflammatory demyelinating neuropathy (CIDP) is an autoimmune-mediated inflammatory neuropathy with chronic progressive or relapsing disease course. The prevalence of CIDP ranges between 2 to 9 per 100.000 individuals per year with marked geographical differences. There is no cure for CIDP and current available treatments often fall short to improve the clinical outcome. In addition most therapies are extremely costly and limited in countries with restricted resources. Therefore CIDP represents a significant burden for affected individuals as well as the health care systems in Europe and India. One of the major problems in the treatment of patients with CIDP is a marked scarcity of biomarkers for early diagnosis and proper differentiation, disease activity and treatment response. This lack of biomarkers often results in delayed diagnosis and wrong classification, in the initiation of ineffective and sometimes harmful treatments and in reserve of industrial partners to develop novel therapies. The aim of this project is therefore to deliver an informative and integrated research program to develop novel biomarkers using innovative imaging and molecular tools and to validate these biomarkers in patients? populations from three countries in two different geographical regions.

Funding scheme:

BEHANDLING-God og treffsikker diagnostikk, behandling og rehabilitering