Byg Keld-Erik, Nielsen Helle H, Sejbaek Tobias, Madsen Jonna Skov, Olsen Dorte Aalund, Nguyen Nina, Kindt Astrid, Grauslund Jakob, Illes Zsolt, Ellingsen Torkell
Department of Neurology, Odense University Hospital, J.B. Winsloewsvej 4, 5000 Odense, Denmark.
BRIDGE-Brain Research-Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, J.B. Winsloesvej 19, 5000 Odense, Denmark.
Brain Sci. 2021 Feb 14;11(2):238. doi: 10.3390/brainsci11020238.
Damage to axonal cells releases neurofilament light chain (NFL) into the cerebrospinal fluid and plasma. The objective of this study was to investigate NFL as a potential biomarker of disease activity in neurosarcoidosis. MRIs were graded according to enhancing lesions at different central nervous system (CNS) sites.
In cerebrospinal fluid, levels of NFL were higher in neurosarcoidosis patients ( = 20) median 2304 pg/mL (interquartile range (IQR) 630-19,612) compared to 426 pg/mL (IQR 261-571) in extra-neurologic sarcoidosis patients ( = 20) and 336 pg/mL (IQR 194-402) in healthy controls ( = 11) ( = 0.0002). In plasma, levels of NFL were higher in neurosarcoidosis patients median 28.2 pg/mL (IQR 11.5-49.3) compared to 6.2 pg/mL (IQR 4.3-8.2) in extra-neurologic sarcoidosis patients and 7.1 pg/mL (IQR 6.2-9.0) in healthy controls ( = 0.0001). Levels in both cerebrospinal fluid and plasma were higher in neurosarcoidosis patients with moderate/severe enhancement than patients with mild enhancement on MRI ( = 0.009 and = 0.005, respectively). To distinguish neurosarcoidosis patients from extra-neurologic patients and healthy controls, a cut-off level of 630 pg/mL in cerebrospinal fluid had 94% specificity and 79% sensitivity, while a cut-off level of 11.4 pg/mL in plasma had 97% specificity and 75% sensitivity.
NFL levels in cerebrospinal fluid and plasma are significantly higher in neurosarcoidosis patients compared to extra-neurologic patients and healthy controls, and the levels correlate to the extent of inflammation on MRI.
轴突细胞损伤会将神经丝轻链（NFL）释放到脑脊液和血浆中。本研究的目的是调查NFL作为神经结节病疾病活动潜在生物标志物的情况。MRI根据不同中枢神经系统（CNS）部位的强化病变进行分级。
在脑脊液中，神经结节病患者（n = 20）的NFL水平中位数为每毫升2304皮克（四分位间距（IQR）630 - 19,612），高于非神经结节病患者（n = 20）的每毫升426皮克（IQR 261 - 571）和健康对照者（n = 11）的每毫升336皮克（IQR 194 - 402）（P = 0.0002）。在血浆中，神经结节病患者的NFL水平中位数为每毫升28.2皮克（IQR 11.5 - 49.3），高于非神经结节病患者的每毫升6.2皮克（IQR 4.3 - 8.2）和健康对照者的每毫升7.1皮克（IQR 6.2 - 9.0）（P = 0.0001）。与MRI轻度强化的神经结节病患者相比，中度/重度强化患者的脑脊液和血浆中NFL水平均更高（分别为P = 0.009和P = 0.005）。为区分神经结节病患者与非神经疾病患者及健康对照者，脑脊液中630皮克/毫升的截断值具有94%的特异性和79%的敏感性，而血浆中11.4皮克/毫升的截断值具有97%的特异性和75%的敏感性。
与非神经疾病患者和健康对照者相比，神经结节病患者脑脊液和血浆中的NFL水平显著更高，且这些水平与MRI上的炎症程度相关。
