Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
J Peripher Nerv Syst. 2018 Sep;23(3):174-177. doi: 10.1111/jns.12279. Epub 2018 Jul 24.
Neurofilament light chain (NFL) levels reflect axonal damage in different inflammatory and neurodegenerative central nervous system conditions, in correlation with disease severity. Our aim was to determine the possible diagnostic and prognostic value of serum and cerebrospinal fluid (CSF) NFL levels in subjects with different forms of acquired peripheral neuropathies (PN). Paired serum and CSF samples of 25 patients with acquired PN were analysed for NFL using an ultrasensitive technique (Quanterix, Simoa, Lexington, MA, USA) and compared with a group of 25 age-matched healthy subjects. Demographic, clinical, CSF and neurophysiological data were reviewed. Cases with Guillain-Barré syndrome (N = 5), multifocal motor neuropathy (N = 3), chronic inflammatory demyelinating polyneuropathy (CIDP) and variants (N = 12), anti-myelin-associated glycoprotein (MAG) neuropathy (N = 3), both CIDP and anti-MAG neuropathy (N = 1), and non-systemic vasculitic neuropathy (N = 1) were studied. NFL levels were significantly (P < 0.001) increased in patients with PN and were higher in the CSF (median: 1407 pg/mL, range: 140.2-12 661) than in serum (median: 31.52 pg/mL, range: 4.33-1178). A statistically significant correlation was observed between serum and CSF levels in cases with blood-nerve-barrier damage (r = 0.71, P < 0.01), and between serum NFL levels and disease activity at sampling (r = 0.52, P < 0.01) and at last follow-up (r = 0.53, P < 0.01) in all subjects. The increase of NFL values in both serum and CSF of patients with acquired PN and the significant correlation between serum NFL levels, disease severity and final outcome support the possible role of NFL as disease activity and prognostic biomarker also in peripheral nervous system disorders.
神经丝轻链（NFL）水平反映了不同炎症性和神经退行性中枢神经系统疾病中的轴突损伤，与疾病严重程度相关。我们的目的是确定血清和脑脊液（CSF）NFL 水平在不同获得性周围神经病（PN）患者中的可能诊断和预后价值。使用超灵敏技术（Quanterix，Simoa，马萨诸塞州列克星敦）分析 25 例获得性 PN 患者的配对血清和 CSF NFL 样本，并与 25 名年龄匹配的健康对照者进行比较。回顾了人口统计学、临床、CSF 和神经生理学数据。研究了格林-巴利综合征（N = 5）、多灶性运动神经病（N = 3）、慢性炎症性脱髓鞘性多发性神经病（CIDP）及其变体（N = 12）、抗髓鞘相关糖蛋白（MAG）神经病（N = 3）、CIDP 和抗 MAG 神经病（N = 1）以及非系统性血管炎性神经病（N = 1）的病例。PN 患者的 NFL 水平显著升高（P < 0.001），且在 CSF 中（中位数：1407 pg/mL，范围：140.2-12661）高于血清（中位数：31.52 pg/mL，范围：4.33-1178）。在有血液-神经屏障损伤的病例中观察到血清和 CSF 水平之间存在统计学显著相关性（r = 0.71，P < 0.01），并且在所有患者中，血清 NFL 水平与采样时的疾病活动度（r = 0.52，P < 0.01）和最后随访时（r = 0.53，P < 0.01）之间存在显著相关性。获得性 PN 患者血清和 CSF 中 NFL 值的升高以及血清 NFL 水平与疾病严重程度和最终结局之间的显著相关性支持 NFL 作为疾病活动度和预后生物标志物在周围神经系统疾病中的可能作用。
