From the Department of Neurology (S.E., F.S., T.U., F.Z., S.B., F.L.), Focus Program Translational Neuroscience (FTN), and Immunotherapy (FZI), Rhine-Main Neuroscience Network (rmn), University Medical Center of the Johannes Gutenberg University; and Institute of Medical Biostatistics (P.S.-K.), Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
Neurol Neuroimmunol Neuroinflamm. 2020 Feb 4;7(3). doi: 10.1212/NXI.0000000000000679. Print 2020 May 4.
To investigate the association of serum neurofilament light chain (sNfL) levels with CSF parameters in clinically isolated syndrome (CIS) and early relapsing-remitting MS (RRMS), taking into account radiologic and clinical parameters of disease activity.
Simultaneously collected serum and CSF samples of 112 untreated patients newly diagnosed with CIS or RRMS were included in this cross-sectional study. CSF parameters were obtained as part of routine diagnostic tests. sNfL levels of patients and of 62 healthy donors were measured by highly sensitive single molecule array (SiMoA) immunoassay.
Patients with RRMS (n = 91, median 10.13 pg/mL, interquartile range [IQR] 6.67-17.77 pg/mL) had higher sNfL levels than healthy donors (n = 62, median 5.25 pg/mL, IQR 4.05-6.81 pg/mL, < 0.001) and patients with CIS (n = 21, median 5.69 pg/mL, IQR 4.73-9.07 pg/mL, < 0.001). Patients positive for oligoclonal bands (OCBs) (n = 101, median 9.19 pg/mL, IQR 6.34-16.38 pg/mL) had higher sNfL levels than OCB-negative patients (n = 11, median 5.93 pg/mL, IQR 2.93-8.56 pg/mL, = 0.001). sNfL levels correlated with CSF immunoglobulin G (IgG) levels ( = 0.317, = 0.002), IgG ratio (QIgG) ( = 0.344, < 0.001), and CSF leukocyte count ( = 0.288, = 0.002). In linear regression modeling, the CSF leukocyte count combined with the number of contrast-enhancing lesions in MRI predicted sNfL levels best.
In active MS, sNfL levels correlate with intrathecal pleocytosis and IgG synthesis, indicating that axonal damage is associated with both acute and chronic CNS-intrinsic inflammation.
探讨血清神经丝轻链（sNfL）水平与临床孤立综合征（CIS）和早期复发缓解型多发性硬化症（RRMS）患者脑脊液（CSF）参数之间的关系，并考虑到疾病活动的放射学和临床参数。
本横断面研究纳入了 112 例新诊断为 CIS 或 RRMS 的未经治疗患者的血清和 CSF 样本。CSF 参数是作为常规诊断测试的一部分获得的。通过高敏单分子阵列（SiMoA）免疫分析测定患者和 62 名健康供体的 sNfL 水平。
RRMS 患者（n=91，中位数 10.13 pg/mL，四分位距 [IQR] 6.67-17.77 pg/mL）的 sNfL 水平高于健康供体（n=62，中位数 5.25 pg/mL，IQR 4.05-6.81 pg/mL，<0.001）和 CIS 患者（n=21，中位数 5.69 pg/mL，IQR 4.73-9.07 pg/mL，<0.001）。寡克隆带（OCB）阳性患者（n=101，中位数 9.19 pg/mL，IQR 6.34-16.38 pg/mL）的 sNfL 水平高于 OCB 阴性患者（n=11，中位数 5.93 pg/mL，IQR 2.93-8.56 pg/mL，=0.001）。sNfL 水平与 CSF 免疫球蛋白 G（IgG）水平（=0.317，=0.002）、IgG 比值（QIgG）（=0.344，<0.001）和 CSF 白细胞计数（=0.288，=0.002）相关。在线性回归模型中，CSF 白细胞计数与 MRI 中增强病变的数量相结合，可最佳预测 sNfL 水平。
在活动性 MS 中，sNfL 水平与鞘内细胞增多症和 IgG 合成相关，表明轴突损伤与急性和慢性中枢神经系统内在炎症均有关。
