Department of Neurology, University of Campinas (UNICAMP), Campinas, Brazil; Neuroimmunology Unit, Department of Genetics, Evolution and Bioagents, University of Campinas (UNICAMP), Campinas, Brazil.
Neuroimmunology Unit, Department of Genetics, Evolution and Bioagents, University of Campinas (UNICAMP), Campinas, Brazil.
Mult Scler Relat Disord. 2019 May;30:149-153. doi: 10.1016/j.msard.2019.02.004. Epub 2019 Feb 5.
A major aim in MS field has been the search for biomarkers that enable accurate detection of neuronal damage. Besides MRI, recent studies have shown that neuroaxonal damage can also be tracked by neurofilament detection. Nevertheless, before widespread implementation, a better understanding of the principal contributors for this biomarker is of paramount importance. Therefore, we analyzed neurofilament light chain (NfL) in relapsing (RMS) and progressive MS (PMS), addressing which MRI and clinical variables are better related to this biomarker.
Forty-seven MS patients underwent MRI (3T) and cerebrospinal fluid (CSF) sampling. We measured NfL concentrations using ELISA (UmanDiagnostics) and performed multivariable regression analysis to assess the contribution of clinical and MRI metrics to NfL.
NfL correlated with previous clinical activity in RMS (p < 0.001). In RMS, NfL also correlated with Gad+ and cortical lesion volumes. However, after multivariable analysis, only cortical lesions and relapses in previous 12 months remained in the final model (R = 0.610; p = 0.009 and p = 0.00008, respectively). In PMS, T1-hypointense lesion volume was the only predictor after multivariate analysis (R = 0.564; p = 0.012).
CSF NfL levels are increased in RMS and associated with relapses and cortical lesions. Although NfL levels were correlated with Gad+ lesion volume, this association did not persist in multivariable analysis after controlling for previous clinical activity. We encourage controlling for previous clinical activity when testing the association of NfL with MRI. In PMS, the major contributor to NfL was T1-hypointense lesion volume.
多发性硬化（MS）领域的一个主要目标是寻找能够准确检测神经元损伤的生物标志物。除 MRI 外，最近的研究还表明，神经丝检测也可以跟踪神经轴突损伤。然而，在广泛应用之前，更好地了解该生物标志物的主要贡献者至关重要。因此，我们分析了复发缓解型多发性硬化症（RMS）和进展型多发性硬化症（PMS）患者的神经丝轻链（NfL），探讨了哪些 MRI 和临床变量与该生物标志物的关系更密切。
47 名 MS 患者接受了 MRI（3T）和脑脊液（CSF）采样。我们使用 ELISA（UmanDiagnostics）测量 NfL 浓度，并进行多变量回归分析，以评估临床和 MRI 指标对 NfL 的贡献。
NfL 与 RMS 中的既往临床活动相关（p<0.001）。在 RMS 中，NfL 还与 Gad+和皮质病变体积相关。然而，在多变量分析后，只有皮质病变和前 12 个月的复发进入了最终模型（R=0.610；p=0.009 和 p=0.00008）。在 PMS 中，T1 低信号病变体积是多变量分析后的唯一预测因子（R=0.564；p=0.012）。
CSF NfL 水平在 RMS 中升高，并与复发和皮质病变相关。尽管 NfL 水平与 Gad+病变体积相关，但在控制既往临床活动后，多变量分析中这种相关性并不存在。我们鼓励在测试 NfL 与 MRI 之间的关联时控制既往临床活动。在 PMS 中，NfL 的主要贡献者是 T1 低信号病变体积。
