Serum neurofilament light chain and glial fibrillary acidic protein in AQP4‐IgG‐seropositive neuromyelitis optica spectrum disorders and multiple sclerosis: A cohort study

Abstract

We investigated the serum neurofilament light chain (sNfL) and glial fibrillary acidic protein (sGFAP) levels in a cohort of Chinese patients with neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS) in relation to clinical disease course and treatment. sNfL and sGFAP levels were determined by ultrasensitive single molecule array (Simoa) assay in patients with NMOSD (n = 102) and MS (n = 98) and healthy controls (HCs; n = 84). Notably, 13 patients with NMOSD and 27 patients with MS were enrolled in the 1‐year follow‐up cohort. Levels were compared with data such as clinical course, disease duration, Expanded Disability Status Scale (EDSS) score, and lesions on MRI. Higher levels of sNfL and sGFAP were found in subjects with NMOSD and MS than in HCs (sNfL, median 12.11, 17.5 vs. 8.88 pg/ml, p < .05; sGFAP, median 130.2, 160.4 vs. 80.01 pg/ml, p < .05). Moreover, sNfL levels were higher in the relapse phase of MS than in the relapse phase of NMOSD (30.02 vs. 14.57 pg/ml, p < .05); sGFAP levels were higher in the remission phase of MS than in the remission phase of NMOSD (159.8 vs. 124.5 pg/ml, p < .01). A higher sGFAP/sNfL quotient at relapse differentiated NMOSD from MS. Multivariate analyses indicated that sGFAP levels were associated with the EDSS score in NMOSD (p < .05). At the 1‐year follow‐up, sNfL and sGFAP levels were both decreased in NMOSD patients in remission, while only sNfL levels were decreased in MS patients in remission. sGFAP and sNfL are potential blood biomarkers for diagnosing and monitoring NMOSD and MS.

Plasma glial fibrillary acidic protein and neurofilament light chain in relation to disability worsening in multiple sclerosis

“…Similar to two previous studies, 8,33 we found no associations between GFAP and disability measures at baseline. Abdelhak et al 9,11 did find correlations between GFAP and EDSS in progressive MS but not in RRMS.…”

“…GFAP was not significantly higher in MS patients than in HCs, in contrast to two previous studies. 6,33 While Högel et al 6 did find higher GFAP in the whole MS cohort (RRMS and SPMS) in comparison with the HCs, levels were similar in RRMS and HCs, like in our study. 6 We found higher GFAP in PPMS than in RRMS, which lost significance after correcting for age.…”

Neurofilament light chain in blood as a diagnostic and predictive biomarker for multiple sclerosis: A systematic review and meta-analysis

“…The other 18 studies that did not declare whether controls were age-matched were then considered as not age-matched studies, even though there was no statistical difference of age at baseline comparison in some studies. As to DMT use, 7 recruited treatment-naïve patients [ 10 , 28 , 32 , 35 , 36 , 42 , 46 ], while the other studies reported a proportion of patients treated with DMT or missing information of DMT use. Quality assessment using NOS for case-control studies identified 19 moderate-quality studies that had 5 or 6 stars and 9 high-quality studies with 7–9 stars ( S2 Table ).…”

Serum and Cerebrospinal Fluid Biomarkers in Neuromyelitis Optica Spectrum Disorder and Myelin Oligodendrocyte Glycoprotein Associated Disease

“…For example, Mariotto et al found higher concentrations of sNfL in patients with MOGAD and NMOSD when compared to MS in samples obtained mostly during disease activity ( 116 ), while Watanabe et al did not find a difference in sNfL values between MS and NMOSD when samples were obtained during remission ( 118 ). Other studies found discordant results with similar levels of sNfL between the two conditions ( 123 ) or even higher values in patients with MS ( 124 ). On the other hand, most studies have found that sGFAP concentration is higher in NMOSD ( 118 , 124 ).…”

“…Finally, serum sGFAP values have been associated with EDSS score ( 118 , 121 – 125 ), Multiple Sclerosis Composite Scale ( 122 ), the occurrence of myelitis ( 118 , 124 ), and a recent relapse ( 118 , 121 ). Conversely, serum sNfL have been associated with EDSS only ( 118 , 121 , 123 , 124 ).…”