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

• Published in: Journal of neurochemistry Vol. 159; no. 5; pp. 913 - 922
• Main Authors: Liu, Chunxin, Lu, Yaxin, Wang, Jingqi, Chang, Yanyu, Wang, Yuge, Chen, Chen, Liu, Zifeng, Kermode, Allan G., Zhang, Yongbiao, Qiu, Wei
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.12.2021
• Subjects: Adult; Aquaporin 4; Aquaporin 4 - blood; Autoimmune diseases; Biomarkers; Biomarkers - blood; Chains; Cohort analysis; Cohort Studies; Disorders; Female; Follow-Up Studies; Glial fibrillary acidic protein; Glial Fibrillary Acidic Protein - blood; Humans; Immunoglobulin G; Immunoglobulin G - blood; Magnetic resonance imaging; Male; Middle Aged; Multiple sclerosis; Multiple Sclerosis - blood; Multiple Sclerosis - diagnosis; neurofilament light chain; Neurofilament Proteins - blood; Neuromyelitis; Neuromyelitis Optica - blood; Neuromyelitis Optica - diagnosis; neuromyelitis optica spectrum disorders; Neuronal-glial interactions; Patients; Proteins; Quotients; Remission; Remission (Medicine); Retrospective Studies; serum biomarker; Simoa; Simoa; neurofilament light chain; glial fibrillary acidic protein; serum biomarker; multiple sclerosis; neuromyelitis optica spectrum disorders
• ISSN: 0022-3042; 1471-4159; 1471-4159
• DOI: 10.1111/jnc.15478

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. Graphical representation can be used to illustrate the rationale, main results, and implications of the study. This study found higher serum levels of neurofilament light chain (sNfL) and glial fibrillary acidic protein (sGFAP) in subjects with neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS) than in controls, all were measured by single molecule array assay (Simoa). This points to the usefulness of these measures as potential blood biomarkers for these neurological disorders. Our study makes a significant contribution to the literature because present techniques of measuring sNfL and sGFAP rely on lumbar puncture, which is extremely invasive. This is a meaningful study of the application of novel neurochemical method to neuroimmune diseases and could lead to less invasive investigations, reducing the burden on patients with these diseases.