ArticleMolecular neurobiology2026
18:2 Cholesterol Ester is a Novel Prognostic Biomarker of Disease Progression in Multiple Sclerosis.
Article in Molecular neurobiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Multiple sclerosis (MS) presents diverse clinical outcomes. Cholesterol esterification (CE) has been implicated as a disease mechanism involved in the remyelination process. We investigated whether cerebrospinal fluid (CSF) 18:2 cholesterol ester (18:2 CE) levels at diagnosis could predict 10-year MS progression. We aimed to determine if CSF 18:2 CE levels correlate with long-term disease progression. In a retrospective case-control single-centre study with 115 MS patients and 57 controls, we conducted targeted lipidomic analysis of CSF. Clinical data, oligoclonal bands, brain and spinal cord MRI, and CSF 18:2 CE levels were collected. Elevated CSF 18:2 CE levels were significantly associated with a higher risk of 10-year MS progression, with an AUC of 0.91 in a multivariable logistic regression model. Patients initially treated with a high-efficacy drug did not show a worse prognosis despite presenting elevated CE18:2 levels at the time of diagnosis. However, patients treated with a high-efficacy drug as a second or third option showed a positive correlation between CE18:2 levels and EDSS at 10 years. CSF 18:2 CE is a potential prognostic biomarker for predicting long-term MS progression, potentially indicating reduced remyelination capacity. These findings hold promise for improved patient management and warrant prospective validation.
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