Prognostic value of cerebrospinal fluid neurofilament light chain and chitinase-3-like-1 in newly diagnosed patients with multiple sclerosis
Prognostic value of cerebrospinal fluid neurofilament light chain and chitinase-3-like-1 in newly diagnosed patients with multiple sclerosis
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DOI：
10.1177/1352458518794308
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发表时间：
2019-10-01
影响因子：
5.8
通讯作者：
Jensen, Poul Erik Hyldgaard
中科院分区：
文献类型：
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作者：
Sellebjerg, Finn;Royen, Lydia;Jensen, Poul Erik Hyldgaard
背景：脑脊液（CSF）中神经丝轻链（NFL）和几丁质酶-3-样-1 （CHI3L1）浓度可能对临床孤立综合征（CIS）和复发-缓解型多发性硬化症（RRMS）具有预后价值。目的：比较脑脊液NFL和CHI3L1浓度在新诊断的CIS和RRMS患者中的预后价值。方法：测定177例新诊断的CIS或RRMS患者脑脊液中NFL和CHI3L1的含量，临床随访平均5.7年。结果：脑脊液NFL的基线浓度与脑脊液CHI3L1浓度、前一年的复发、上一次复发的时间和扩展残疾状态量表（EDSS）评分相关。在单变量分析中，脑脊液NFL和CHI3L1浓度均与前2年复发风险增加相关，但在多变量分析中，只有脑脊液NFL浓度与复发风险独立相关。脑脊液NFL或CHI3L1浓度与转化为继发性进展性MS或发展为残疾的风险之间没有关系。结论：在新诊断的CIS和RRMS患者中，脑脊液NFL浓度与2年复发风险相关，但与疾病进展或临床恶化无关。这可能是由于疾病修饰疗法的影响造成的混淆。
Background: Neurofilament light chain (NFL) and chitinase-3-like-1 (CHI3L1) concentrations in cerebrospinal fluid (CSF) may have prognostic value in clinically isolated syndromes (CIS) and relapsing-remitting multiple sclerosis (RRMS). Objectives: To compare the prognostic value of CSF concentrations of NFL and CHI3L1 in newly diagnosed CIS and RRMS patients. Methods: NFL and CHI3L1 were measured in CSF in 177 newly diagnosed patients with CIS or RRMS who were followed clinically for a mean of 5.7 years. Results: At baseline CSF concentrations of NFL correlated with CSF concentrations of CHI3L1, relapses in the previous year, time from last relapse, and the Expanded Disability Status Scale (EDSS) score. CSF concentrations of NFL and CHI3L1 were both associated with increased relapse risk during the first 2 years in univariate analyses, but only the CSF concentration of NFL was independently associated with relapse risk in a multivariable analysis. There was no relationship between CSF concentrations of NFL or CHI3L1 and risk of conversion to secondary progressive MS or development of disability. Conclusion: CSF concentrations of NFL are associated with 2-year relapse risk but not with disease progression or clinical worsening in newly diagnosed CIS and RRMS patients. This may be due to confounding by the effect of disease-modifying therapies.