Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Halle (Saale), Germany.
Department of Neurology, University of California San Francisco (UCSF), San Francisco, USA.
Brain. 2023 Feb 13;146(2):421-437. doi: 10.1093/brain/awac328.
The advancing validation and exploitation of CSF and blood neurofilament light chain protein as a biomarker of neuroaxonal damage has deeply changed the current diagnostic and prognostic approach to neurological diseases. Further, recent studies have provided evidence of potential new applications of this biomarker also in non-primary neurological diseases. In the present review we summarize the state of the art, future perspectives, but also limitations, of neurofilament light chain protein as a CSF and blood biomarker in several medical fields, including intensive care medicine, surgery, internal medicine and psychiatry. In particular, neurofilament light chain protein is associated with the degree of neurological impairment and outcome in patients admitted to intensive care units or in the perioperative phase and it seems to be highly interconnected with cardiovascular risk factors. Beyond that, interesting diagnostic and prognostic insights have been provided by the investigation of neurofilament light chain protein in psychiatric disorders as well as in the current coronavirus disease-19 pandemic and in normal ageing. Altogether, current data outline a multifaceted applicability of CSF and blood neurofilament light chain protein ranging from the critical clinical setting to the development of precision medicine models suggesting a strict interplay between the nervous system pathophysiology and the health-illness continuum.
脑脊液和血液神经丝轻链蛋白作为神经轴索损伤的生物标志物，其验证和应用的不断推进，极大地改变了神经疾病当前的诊断和预后方法。此外，最近的研究为这一生物标志物在非原发性神经疾病中的潜在新应用提供了证据。在本综述中，我们总结了神经丝轻链蛋白作为脑脊液和血液生物标志物在包括重症监护医学、外科、内科和精神病学在内的几个医学领域的最新进展、未来展望，但也指出了其局限性。神经丝轻链蛋白与入住重症监护病房或围手术期患者的神经损伤程度和预后相关，并且似乎与心血管危险因素高度相关。除此之外，在精神疾病以及当前的 COVID-19 大流行和正常衰老中对神经丝轻链蛋白的研究提供了有趣的诊断和预后见解。总的来说，目前的数据描绘了脑脊液和血液神经丝轻链蛋白的多方面适用性，从关键的临床环境到精准医学模型的发展，提示神经系统病理生理学与健康-疾病连续体之间存在密切的相互作用。
