Serum neurofilament light chain levels are increased in patients with a clinically isolated syndrome
Serum neurofilament light chain levels are increased in patients with a clinically isolated syndrome
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DOI：
10.1136/jnnp-2014-309690
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发表时间：
2016-02-01
影响因子：
11
通讯作者：
Ramagopalan, Sreeram V.
中科院分区：
文献类型：
--
作者：
Disanto, Giulio;Adiutori, Rocco;Ramagopalan, Sreeram V.
背景神经丝轻链 (NfL) 是一种很有前景的轴突损伤生物标志物。我们提出了第一个关于临床孤立综合征 (CIS) 患者和健康对照者血清 NfL 的探索性研究。方法 我们研究了 100 名 CIS 患者的血清 NfL 水平，这些患者的转换间隔较短，转为临床明确的多发性硬化症 (MS)（快速转换 (FC)，中位 (IQR) 转换时间：110 天 (79-139)）； 98 名未转化 CIS 患者（未转化者 (NC)，随访时间：6.5 年 (5.3-7.9)）；结果 FC (24.1 pg/mL (13.5-51.8)) 和 NC (19.3 pg/mL (13.6-35.2)) 中的 NfL 水平高于健康对照 (7.9 pg/mL (5.6-17.2)) (OR=5.85; 95% CI 2.63 至 13.02; p=1.5x10(-5) 并且 或=7.03； 95% CI 2.85 至 17.34； p=2.3x10(-5)，分别）。当将 FC 和 NC 分组时，血清 NfL 浓度升高还与 T2 高信号 MRI 病变数量增加（OR=2.36；95% CI 1.21 至 4.59；p=0.011）、钆增强病变（OR=2.69；95% CI 1.13 至 6.41；p=0.026）和更高的残疾评分（OR=2.54；p=0.026）相关。 95%置信区间 1.21至5.31； p=0.013）在 CIS 诊断中。 结论 如果在未来的研究中重复，血清 NfL 可能代表 CIS 和 MS 早期轴突损伤的可靠且易于获取的生物标志物。
Background Neurofilament light chain (NfL) represents a promising biomarker for axonal injury. We present the first exploratory study on serum NfL in patients with a clinically isolated syndrome (CIS) and healthy controls.Methods We investigated serum NfL levels in 100 patients with CIS with a short conversion interval to clinically definite multiple sclerosis (MS) (fast converters (FC), median (IQR) conversion time: 110 days (79-139)); 98 patients with non-converting CIS (non-converters (NC), follow-up: 6.5 years (5.3-7.9)); and 92 healthy controls.Results NfL levels were higher in FC (24.1 pg/mL (13.5-51.8)) and NC (19.3 pg/mL (13.6-35.2)) than in healthy controls (7.9 pg/mL (5.6-17.2)) (OR=5.85; 95% CI 2.63 to 13.02; p=1.5x10(-5) and OR=7.03; 95% CI 2.85 to 17.34; p=2.3x10(-5), respectively). When grouping FC and NC, increased serum NfL concentration was also associated with increasing numbers of T2 hyperintense MRI lesions (OR=2.36; 95% CI 1.21 to 4.59; p=0.011), gadolinium-enhancing lesions (OR=2.69; 95% CI 1.13 to 6.41; p=0.026) and higher disability scores (OR=2.54; 95% CI 1.21 to 5.31; p=0.013) at CIS diagnosis.Conclusions If replicated in future studies, serum NfL may represent a reliable and easily accessible biomarker of early axonal damage in CIS and MS.