Domingues Renan Barros, Fernandes Gustavo Bruniera Peres, Leite Fernando Brunale Vilela de Moura, Senne Carlos
Senne Liquor Diagnóstico, São Paulo, SP, Brasil.
Arq Neuropsiquiatr. 2019 Jul 15;77(6):436-441. doi: 10.1590/0004-282X20190060.
Multiple sclerosis (MS) is an autoimmune, inflammatory, and degenerative disease of the central nervous system. Axonal degeneration is triggered by inflammation and is the pathological substrate of progressive disability in patients with MS. Therapeutic interventions can reduce inflammatory activity, thus delaying neurodegeneration and the progression of disability. Disease activity and neurodegeneration are assessed mainly through clinical evaluation and magnetic resonance imaging. These measures lack sensitivity and accuracy, so new biomarkers are necessary. Several markers have been studied and to date the most promising is neurofilament light (NfL), a component of the axonal cytoskeleton, which is released into cerebrospinal fluid (CSF) following axonal damage. In the present study, we review the current knowledge about CSF NfL determination in MS, clinically isolated syndrome, and radiologically isolated syndrome, and critically discuss how CSF NfL measurement may contribute to therapeutic decision-making in these patients.
多发性硬化症（MS）是一种中枢神经系统的自身免疫性、炎症性和退行性疾病。轴突退变由炎症触发，是MS患者进行性残疾的病理基础。治疗干预可降低炎症活性，从而延缓神经退变和残疾进展。疾病活动和神经退变主要通过临床评估和磁共振成像进行评估。这些措施缺乏敏感性和准确性，因此需要新的生物标志物。已经研究了几种标志物，迄今为止最有前景的是神经丝轻链（NfL），它是轴突细胞骨架的一个组成部分，在轴突损伤后释放到脑脊液（CSF）中。在本研究中，我们回顾了目前关于在MS、临床孤立综合征和放射学孤立综合征中脑脊液NfL测定的知识，并批判性地讨论了脑脊液NfL测量如何有助于这些患者的治疗决策。
