Department of Neurology, MS Centre ErasMS, Erasmus MC, Rotterdam, The Netherlands.
Department of Immunology, MS Centre ErasMS, Erasmus MC, Rotterdam, The Netherlands.
Mult Scler. 2019 Jun;25(7):958-967. doi: 10.1177/1352458518775303. Epub 2018 May 18.
A promising biomarker for axonal damage early in the disease course of multiple sclerosis (MS) is neurofilament light chain (NfL). It is unknown whether NfL has the same predictive value for MS diagnosis in children as in adults.
To explore the predictive value of NfL levels in cerebrospinal fluid (CSF) for MS diagnosis in paediatric and adult clinically isolated syndrome (CIS) patients.
A total of 88 adult and 65 paediatric patients with a first attack of demyelination were included and followed (mean follow up-time in adults: 62.8 months (standard deviation (SD) ±38.7 months) and 43.8 months (SD ±27.1 months) in children). Thirty control patients were also included. Lumbar puncture was done within 6 months after onset of symptoms. NfL was determined in CSF using enzyme-linked immunosorbent assay (ELISA). COX regression analyses were used to calculate hazard ratios (HR) for clinically definite multiple sclerosis (CDMS) diagnosis.
After adjustments for age, oligoclonal bands (OCB), and asymptomatic T2 lesions on baseline magnetic resonance imaging (MRI), increased NfL levels in both paediatric and adult CIS patients were associated with a shorter time to CDMS diagnosis (children HR = 3.7; p = 0.007, adults HR = 2.1; p = 0.032). For CIS patients with a future CDMS diagnosis, children showed higher NfL levels than adults (geometric mean 4888 vs 2156 pg/mL; p = 0.007).
CSF NfL levels are associated with CDMS diagnosis in children and adults with CIS. This makes NfL a promising predictive marker for disease course with potential value in clinical practice.
神经丝轻链（NfL）是多发性硬化症（MS）疾病早期轴索损伤的一个有前途的生物标志物。目前尚不清楚 NfL 在儿童 MS 诊断中的预测价值是否与成人相同。
探讨脑脊液（CSF）中 NfL 水平对儿科和成人临床孤立综合征（CIS）患者 MS 诊断的预测价值。
共纳入 88 例成人和 65 例儿童首次脱髓鞘发作患者，并进行随访（成人平均随访时间：62.8 个月（标准差（SD）±38.7 个月）和 43.8 个月（SD±27.1 个月）；儿童）。还纳入了 30 名对照患者。所有患者均在症状出现后 6 个月内行腰椎穿刺。使用酶联免疫吸附试验（ELISA）法测定 CSF 中的 NfL。采用 COX 回归分析计算临床确诊多发性硬化症（CDMS）诊断的危险比（HR）。
在校正年龄、寡克隆带（OCB）和基线磁共振成像（MRI）上无症状的 T2 病变后，儿科和成人 CIS 患者的 NfL 水平升高均与 CDMS 诊断时间缩短相关（儿童 HR=3.7；p=0.007，成人 HR=2.1；p=0.032）。对于未来有 CDMS 诊断的 CIS 患者，儿童的 NfL 水平高于成人（几何均数 4888 比 2156pg/ml；p=0.007）。
CSF NfL 水平与 CIS 儿童和成人的 CDMS 诊断相关。这使得 NfL 成为疾病过程的一个很有前途的预测标志物，具有潜在的临床应用价值。
