Neuro Center, Neurology Outpatient Clinic, Kuopio University Hospital, P.O. BOX 100, Kuopio FI-70029, Finland.
Institute of Clinical Medicine-Neurology, University of Eastern Finland, Kuopio, Finland.
Mult Scler Relat Disord. 2021 Nov;56:103280. doi: 10.1016/j.msard.2021.103280. Epub 2021 Sep 28.
We aimed to investigate serum glial fibrillary acidic protein (GFAP) and serum neurofilament light chain (NfL) levels as potential discriminative biomarkers between benign relapsing-remitting multiple sclerosis (BRRMS) and aggressive relapsing-remitting MS (ARRMS).
Serum GFAP and NfL levels were analyzed in patients with BRRMS (n = 34), ARRMS (n = 29), and healthy controls (n = 14) by using Single Molecule Array (Simoa). Patients with ARRMS had been treated with highly effective disease-modifying treatments (DMT) (fingolimod or natalizumab).
Serum GFAP levels in both BRRMS (median 210.19 pg/ml, IQR 163.69-287.19) and in ARRMS (median 188.60 pg/ml, IQR39.23-244.93) were significantly higher (p = 0.035 and p = 0.034, respectively) compared to healthy controls (median 117.93 pg/ml, IQR 60.28-183.83). Serum GFAP levels did not differ between BRRMS and ARRMS. There were no statistical differences in NfL levels between BRRMS, ARRMS and healthy controls. GFAP level was significantly higher (p = 0.04) in BRRMS without DMT (median 216.04 pg/ml, IQR 188.60-274.79) than in those BRRMS patients who had used DMT (median 196.26 pg/ml, IQR 133.33-325.54).
We found elevated levels of serum GFAP in both BRRMS and ARRMS compared to healthy controls, reflecting astrocytic activation. Serum NfL did not differ between BRRMS and ARRMS, probably due to the stable inflammatory phase of the disease and effective DMT use in ARRMS. Single serum NfL and GFAP measurements cannot separate a patient with BRRMS from effectively treated ARRMS after a long history of the disease, thus consecutive samples are needed in the follow-up.
我们旨在研究血清神经胶质纤维酸性蛋白（GFAP）和血清神经丝轻链（NfL）水平作为良性复发性缓解型多发性硬化症（BRRMS）和侵袭性复发性多发性硬化症（ARRMS）之间潜在鉴别生物标志物的作用。
通过单分子阵列（Simoa）分析 BRRMS 患者（n=34）、ARRMS 患者（n=29）和健康对照者（n=14）的血清 GFAP 和 NfL 水平。ARRMS 患者接受了高效疾病修正治疗（DMT）（芬戈莫德或那他珠单抗）。
BRRMS 患者（中位数 210.19 pg/ml，IQR 163.69-287.19）和 ARRMS 患者（中位数 188.60 pg/ml，IQR 39.23-244.93）的血清 GFAP 水平均显著高于健康对照组（中位数 117.93 pg/ml，IQR 60.28-183.83）（p=0.035 和 p=0.034）。BRRMS 和 ARRMS 之间的血清 GFAP 水平无差异。BRRMS、ARRMS 和健康对照组之间的 NfL 水平无统计学差异。未接受 DMT 的 BRRMS 患者的 GFAP 水平显著更高（p=0.04）（中位数 216.04 pg/ml，IQR 188.60-274.79），而接受 DMT 的 BRRMS 患者的 GFAP 水平显著更低（中位数 196.26 pg/ml，IQR 133.33-325.54）。
与健康对照组相比，我们发现 BRRMS 和 ARRMS 患者的血清 GFAP 水平均升高，反映了星形胶质细胞的激活。BRRMS 和 ARRMS 之间的血清 NfL 水平无差异，这可能是由于疾病的炎症稳定阶段和 ARRMS 中有效 DMT 的使用。单次血清 NfL 和 GFAP 测量不能将患有 BRRMS 的患者与经过长期疾病治疗后效果良好的 ARRMS 患者区分开来，因此需要在随访中连续采样。
