Serum neurofilament light chain in chronic inflammatory demyelinating polyneuropathy

Abstract

Objectives Neurofilament light chain (NfL) levels have been suggested as reflecting axonal damage in various inflammatory and neurodegenerative disorders, including acquired peripheral neuropathies. We aimed to investigate if serum NfL (sNfL) levels can be a biomarker of disease activity and treatment response in patients with chronic inflammatory demyelinating polyneuropathy (CIDP). Materials and methods The sNfL levels of eleven newly diagnosed patients with CIDP were retrospectively assayed and compared with seven healthy volunteers. The levels were assayed before and after intravenous immunoglobulin treatment in patients with CIDP and were also assayed in the remission period. Results Baseline sNfL levels in patients with CIDP before treatment were significantly higher than those in healthy controls. The levels significantly decreased overtime after one month of treatment and in remission period. There were significant negative correlations between the sNfL levels and the disease duration (the interval between the onset of the disease and the time of sampling), and weak correlations between the sNfL levels and overall neuropathy limitations scale. Conclusions sNfL may be a potential biomarker reflecting the disease activity in patients with CIDP.

Calprotectin in Chronic Inflammatory Demyelinating Polyneuropathy and Variants—A Potential Novel Biomarker of Disease Activity

“…For emphasis and in order to reflect realworld-setting, we additionally examined the relationship of sNfl in regard to clinical characteristics and PRO parameters. The latter has not been investigated in other studies so far (21)(22)(23)(24), although we found no significant relationship. Despite recent advances in biomarker research for CIDP, nodal, paranodal, and anti-ganglioside antibodies (aGAAbs) can be detected only in a small proportion of patients (7,8).…”

“…Our study confirms previous findings of elevated sNfl levels in patients with CIDP ( 21 – 24 ), although direct comparison of sNfl levels between studies should be done with caution, as methods of sNfl measurement vary. Hayashi et al ( 23 ) found significantly elevated sNfl levels in 11 treatment naïve CIDP patients, which decreased after 1 month of IVIG therapy. Similar data were obtained by van Lieverloo et al, who found elevated sNlf levels in 29 patients starting induction therapy ( 21 ).…”

“…There is increasing evidence that serum neurofilament light chain (sNfl), which is released upon neuronal injury (20), is increased in patients with CIDP and correlates with markers of disease severity (21)(22)(23)(24). Nevertheless, the major limitation of sNfl is the lack of age-specific cutoff values (25,26).…”

Axonal damage determines clinical disability in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP): A prospective cohort study of different CIDP subtypes and disease stages

“…Neurofilament light chain (NfL), electromyography and muscle ultrasonography studies support the association of axonal loss with clinical disability in several ways. First, NfL levels in pre-treated CIDP patients were significantly increased compared to healthy controls and patients after immunotherapy induction [26,27] and NfL level was able to predict 1-year disease progression [28]. Second, evidence of PSA on electromyography in CIDP has been associated with a worse long-term outcome [11].…”

Elevation of Neurodegenerative Serum Biomarkers among Hospitalized COVID-19 Patients

“…However, none of these studies explicitly excluded COVID-19 patients with a baseline history of dementia or cognitive decline, which likely would confound results. Additionally, NFL is not specific to the CNS and can be elevated in the context of peripheral neuropathy (45)(46)(47), including COVID-related critical illness neuropathy/myopathy (7) and Guillain-Barre Syndrome (47). Similarly, elevated GFAP has been reported in COVID-19 patients with critical illness neuropathy/myopathy and levels correlate with nerve amplitudes (7).…”