Genetics

Imagine being able to tell, right at diagnosis, whether multiple sclerosis (MS) will simmer quietly or erupt with fresh relapses and MRI lesions over the next few years. A 2025 Italian study followed 1,294 people with MS on first-line therapies for four years and scanned nearly seven million genetic variants to find out. The researchers uncovered clusters of tiny DNA differences—especially near genes that control mitochondrial energy, antioxidant defenses, immune complement cascades, and even our body clocks—that together seem to tip the balance toward either calm or active disease. While no single “villain” gene emerged, the work suggests that a polygenic “activity score” could one day guide doctors to escalate treatment sooner for those whose genomes signal a stormy road ahead.