Serum neurofilament light chain and glial fibrillary acidic protein in AQP4-IgG-seropositive neuromyelitis optica spectrum disorders and multiple sclerosis: A cohort study

J Neurochem. 2021 Dec;159(5):913-922. doi: 10.1111/jnc.15478. Epub 2021 Jul 28.

Abstract

We investigated the serum neurofilament light chain (sNfL) and glial fibrillary acidic protein (sGFAP) levels in a cohort of Chinese patients with neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS) in relation to clinical disease course and treatment. sNfL and sGFAP levels were determined by ultrasensitive single molecule array (Simoa) assay in patients with NMOSD (n = 102) and MS (n = 98) and healthy controls (HCs; n = 84). Notably, 13 patients with NMOSD and 27 patients with MS were enrolled in the 1-year follow-up cohort. Levels were compared with data such as clinical course, disease duration, Expanded Disability Status Scale (EDSS) score, and lesions on MRI. Higher levels of sNfL and sGFAP were found in subjects with NMOSD and MS than in HCs (sNfL, median 12.11, 17.5 vs. 8.88 pg/ml, p < .05; sGFAP, median 130.2, 160.4 vs. 80.01 pg/ml, p < .05). Moreover, sNfL levels were higher in the relapse phase of MS than in the relapse phase of NMOSD (30.02 vs. 14.57 pg/ml, p < .05); sGFAP levels were higher in the remission phase of MS than in the remission phase of NMOSD (159.8 vs. 124.5 pg/ml, p < .01). A higher sGFAP/sNfL quotient at relapse differentiated NMOSD from MS. Multivariate analyses indicated that sGFAP levels were associated with the EDSS score in NMOSD (p < .05). At the 1-year follow-up, sNfL and sGFAP levels were both decreased in NMOSD patients in remission, while only sNfL levels were decreased in MS patients in remission. sGFAP and sNfL are potential blood biomarkers for diagnosing and monitoring NMOSD and MS.

Keywords: Simoa; glial fibrillary acidic protein; multiple sclerosis; neurofilament light chain; neuromyelitis optica spectrum disorders; serum biomarker.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aquaporin 4 / blood*
  • Biomarkers / blood
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Glial Fibrillary Acidic Protein / blood*
  • Humans
  • Immunoglobulin G / blood*
  • Male
  • Middle Aged
  • Multiple Sclerosis / blood*
  • Multiple Sclerosis / diagnosis
  • Neurofilament Proteins / blood*
  • Neuromyelitis Optica / blood*
  • Neuromyelitis Optica / diagnosis
  • Retrospective Studies

Substances

  • AQP4 protein, human
  • Aquaporin 4
  • Biomarkers
  • GFAP protein, human
  • Glial Fibrillary Acidic Protein
  • Immunoglobulin G
  • Neurofilament Proteins
  • neurofilament protein L