University Hospital Ostrava, Institute of Laboratory Medicine, Department of Clinical Biochemistry, Ostrava, Czech Republic; University of Ostrava, Institute of Laboratory Medicine, Ostrava, Czech Republic.
University Hospital Ostrava, Department of Neurology, Ostrava, Czech Republic; University of Ostrava, Department of Clinical Neurosciences, Ostrava, Czech Republic.
Mult Scler Relat Disord. 2024 Nov;91:105915. doi: 10.1016/j.msard.2024.105915. Epub 2024 Oct 2.
The aim of this study was to evaluate the association of serum neurofilament heavy chain (sNfH) and chitinase 3-like 1 (sCHI3L1) with treatment response and disease activity in multiple sclerosis (MS).
This single-center, prospective, observational cohort study was conducted at the MS Centre, University Hospital Ostrava, Czech Republic, from May 2020 to August 2023. sNfH and sCHI3L1 were determined using ELISA. A mixed-effects linear model with a log-transformed outcome variable was applied.
We analyzed 459 samples from 57 people with MS. Patients were sampled an average of 8.05 times during 21.9 months of follow-up. Those experiencing a relapse at sampling had a sNfH concentration 50 % higher than those in remission (exp(β) 1.5, 95 % CI 1.15-1.96). A longer duration of treatment was associated with lower sNfH (exp(β) 0.95, 95 % CI 0.94-0.96). Patients switched from low- to high-efficacy disease-modifying therapies (DMTs) had higher sNfH than patients treated with low-efficacy DMTs only (exp(β) 1.95, 95 % CI 1.35-2.81). Higher sCHI3L1 was associated with older age (exp(β) 1.01, 95 % CI 1.00-1.02) and longer DMT use (exp(β) 1.01, 95 % CI 1.00-1.02). sCHI3L1 values were not associated with relapse at the time of sampling, renal function, sex, or type of DMT.
In contrast to sCHI3L1, sNfH may be a potential biomarker for monitoring treatment response and confirming clinical relapse in MS. Further research is needed to determine the long-term dynamics of sNfH and develop related treatment strategies.
本研究旨在评估血清神经丝重链（sNfH）和几丁质酶 3 样蛋白 1（sCHI3L1）与多发性硬化症（MS）治疗反应和疾病活动的相关性。
这项单中心、前瞻性、观察性队列研究于 2020 年 5 月至 2023 年 8 月在捷克奥斯特拉瓦大学医院的 MS 中心进行。使用 ELISA 法测定 sNfH 和 sCHI3L1。采用对数转换因变量的混合效应线性模型进行分析。
我们分析了 57 名 MS 患者的 459 份样本。在 21.9 个月的随访期间，患者平均采样 8.05 次。在采样时发生复发的患者的 sNfH 浓度比缓解期患者高 50%（exp(β) 1.5，95%CI 1.15-1.96）。治疗时间延长与 sNfH 降低相关（exp(β) 0.95，95%CI 0.94-0.96）。从低疗效疾病修正治疗（DMT）转为高疗效 DMT 的患者的 sNfH 高于仅接受低疗效 DMT 治疗的患者（exp(β) 1.95，95%CI 1.35-2.81）。较高的 sCHI3L1 与年龄较大（exp(β) 1.01，95%CI 1.00-1.02）和较长的 DMT 使用时间（exp(β) 1.01，95%CI 1.00-1.02）相关。sCHI3L1 值与采样时的复发、肾功能、性别或 DMT 类型无关。
与 sCHI3L1 不同，sNfH 可能是监测 MS 治疗反应和确认临床复发的潜在生物标志物。需要进一步研究以确定 sNfH 的长期动态变化并制定相关的治疗策略。
