Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at The University of Gothenburg, Mölndal, Sweden.
Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.
Clin Chem Lab Med. 2023 Mar 7;61(7):1140-1149. doi: 10.1515/cclm-2023-0036. Print 2023 Jun 27.
Neurobiomarkers have attracted significant attention over the last ten years. One promising biomarker is the neurofilament light chain protein (NfL). Since the introduction of ultrasensitive assays, NfL has been developed into a widely used axonal damage marker of relevance to the diagnosis, prognostication, follow-up, and treatment monitoring of a range of neurological disorders, including multiple sclerosis, amyotrophic lateral sclerosis, and Alzheimer's disease. The marker is increasingly used clinically, as well as in clinical trials. Even if we have validated precise, sensitive, and specific assays for NfL quantification in both cerebrospinal fluid and blood, there are analytical, as well as pre- and post-analytical aspects of the total NfL testing process, including biomarker interpretation, to consider. Although the biomarker is already in use in specialised clinical laboratory settings, a more general use requires some further work. In this review, we provide brief basic information and opinions on NfL as a biomarker of axonal injury in neurological diseases and pinpoint additional work needed to facilitate biomarker implementation in clinical practice.
神经生物标志物在过去十年中引起了广泛关注。一种很有前途的生物标志物是神经丝轻链蛋白（NfL）。自从引入超敏检测方法以来，NfL 已发展成为一种广泛使用的轴突损伤标志物，与多种神经疾病的诊断、预后、随访和治疗监测有关，包括多发性硬化症、肌萎缩侧索硬化症和阿尔茨海默病。该标志物在临床上以及临床试验中越来越多地被使用。即使我们已经验证了用于脑脊液和血液中 NfL 定量的精确、敏感和特异性检测方法，但仍需要考虑总 NfL 检测过程的分析以及分析前和分析后的各个方面，包括生物标志物的解释。尽管该生物标志物已经在专门的临床实验室环境中使用，但更广泛的应用还需要做一些进一步的工作。在这篇综述中，我们简要介绍了 NfL 作为神经疾病轴突损伤生物标志物的基本信息和观点，并指出了在临床实践中促进生物标志物应用所需的额外工作。
