Second Department of Pediatrics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Department of Neonatology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
J Neurol. 2023 Oct;270(10):4753-4762. doi: 10.1007/s00415-023-11841-9. Epub 2023 Jul 2.
Multiple sclerosis is a neuro-inflammatory disease that affects adults and children and causes somatic and cognitive symptoms. Diagnosis after the first clinical symptoms is challenging, involves laboratory and magnetic resonance imaging work-up and is often inconclusive unless subsequent clinical attacks occur. Neurofilament light chains are structural proteins within neurons. Levels of this marker in cerebrospinal fluid, plasma and serum are consistently higher in patients with an initial clinical demyelinating attack that later go on to develop multiple sclerosis. Evidence concerning serum levels of this biomarker in children with multiple sclerosis is scarce. Our aim is to review and analyze the evidence available for patients with multiple sclerosis, under the age of 18.
We conducted a systematic search of PubMed/Medline, Embase, Cochrane Database, and ProQuest. Human studies that provided data on serum levels of Neurofilament light chains in pediatric patients with MS, measured at the time of the first demyelinating attack and before treatment were included in meta-analysis.
Three studies satisfied the inclusion criteria. 157 pediatric patients with multiple sclerosis and 270 hospital-based controls that did not present with this condition were included in the analysis. A fixed effects meta-analysis showed that the standardized mean difference between patients and controls is 1.82, with a 95% confidence interval of [1.56-2.08].
Pediatric patients with multiple sclerosis show higher levels of serum neurofilament light chains at their first clinical demyelinating attack compared to pediatric hospital-based controls.
多发性硬化症是一种影响成人和儿童的神经炎症性疾病，可导致躯体和认知症状。首次出现临床症状后的诊断具有挑战性，需要进行实验室和磁共振成像检查，但通常无法得出明确结论，除非随后出现临床发作。神经丝轻链是神经元内的结构蛋白。在初次临床脱髓鞘发作后发展为多发性硬化症的患者中，脑脊液、血浆和血清中该标志物的水平始终较高。关于多发性硬化症儿童血清水平的证据很少。我们的目的是回顾和分析 18 岁以下多发性硬化症患者的现有证据。
我们对 PubMed/Medline、Embase、Cochrane 数据库和 ProQuest 进行了系统搜索。纳入的研究为在首次脱髓鞘发作时且在治疗前测量血清神经丝轻链水平的儿童多发性硬化症患者提供了数据。
有 3 项研究符合纳入标准。共纳入 157 例多发性硬化症儿科患者和 270 例未患有该疾病的医院对照者。固定效应荟萃分析显示，患者与对照组之间的标准化均数差值为 1.82，95%置信区间为[1.56-2.08]。
与儿科医院对照者相比，多发性硬化症儿科患者在首次临床脱髓鞘发作时表现出更高的血清神经丝轻链水平。
