Research: Tau in MS

EpubJaworski et al. Total-tau in cerebrospinal fluid of patients with multiple sclerosis decreases in secondary progressive stage of disease and reflects degree of brain atrophy. Ups J Med Sci. 2012 May 4.

Introduction: Tau protein is a potential marker of neuronal damage. The aim of the study is to investigate its potential role as a marker of brain atrophy in multiple sclerosis (MS).

Materials and methods: Cerebrospinal fluid (CSF) and blood samples were collected from 48 patients with multiple sclerosis. Total-tau (t-tau) and phospho(181Thr)-tau (p-tau) (Tau with a phosphate on it = phosphorylation = a marker of activation of the protein that is pphosphorylated) concentrations were assayed with commercially available INNOTEST® hTAU Ag and INNOTEST® phospho181Thr-tau((181P)) and correlated with indices of brain atrophy in magnetic resonance imaging (MRI) and clinical characteristics of the study population.

Results: T-tau concentration in CSF was significantly higher in relapsing-remitting (RR) compared to secondary progressive (SP) MS patients (P = 0.01). Brain parenchymal fraction (BPF) was significantly decreased in SP patients (P = 0.002). BPF in the whole study population correlated inversely with Expanded Disability Status Scale (EDSS) (r = -0.51, P = 0.0002) and Multiple Sclerosis Severity Score (MSSS) (r = -0.42, P = 0.002). T-tau in CSF in the whole patient group correlated inversely with EDSS (r = -0.58, P = 0.0006).

Conclusions: The results of our study suggest that total-tau concentration in CSF in a MS population decreases in the course of disease and reflects degree of parenchymal brain loss.




Tau is a protein that had been associated with nerve damage in Alzheimers disease and (we + friends of Team G) were the first group to show that this molecule is present in both MS and a animal model of MS, when nerve damage is occurring. This current study looked to see if they could detect Tau in different stages of MS and tried to link it to disability.The more BPF fraction as detected by MRI the lower was the disability assessed by EDSS. The more Tau in the cerebrospinal fluid was not associated with high disability and it was present in the higher levels during relapsing remitting MS than secondary progressive MS. Although perhaps the authors were looking for more in secondary progressive MS as they would probably like to link it to neuronal damage and death. This does not surprise me as much of the damage is occuring during the highly inflammatory period so al ot of damage can occurs in short bursts as lesions come and go. However in secondary progression the damage slowly grumbles on and so the Tau protein will trickle out in comparison to a flow during RRMS. We saw this with neurofilament in the blood in our animal modle where we see step-wise increases in disability with each attack (so relapses are not a good thing and they are not inert) and find neurofilament, which is also a marker of damage. This goes to low levels in the blood when the progressive disability occurs.

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