Neurofilament and glial fibrillary acidic protein in multiple sclerosis.
OBJECTIVE
To evaluate levels of neurofilament light (NFL) and glial fibrillary acidic protein (GFAP) in CSF from patients with multiple sclerosis (MS) in relation to clinical progress of the disease.


METHODS
CSF levels of NFL and GFAP were determined by sensitive ELISAs in 99 patients with different subtypes of MS, classified in terms of "ongoing relapse" or "clinically stable disease," and 25 control subjects. Levels were compared with paraclinical data such as immunoglobulin G index and inflammatory cell count in the CSF, and the levels were related to Expanded Disability Status Scale score and progression index at clinical follow-up evaluations later in the disease course.


RESULTS
NFL and GFAP levels were elevated in MS patients as compared with control subjects (p < 0.001). The NFL levels were higher at relapses, whereas GFAP levels were unaffected. High NFL levels correlated with progression in patients with an active relapse (r = 0.49; p < 0.01) and in clinically stable patients (r = 0.29; p < 0.05). GFAP correlated to progression in the total patient cohort (r = 0.24; p < 0.05). Moreover, a strong correlation between NFL levels and inflammatory cell counts was evident in the group of patients with an ongoing relapse (r = 0.52; p = 0.001).


CONCLUSIONS
CSF levels of neurofilament light and glial fibrillary acidic protein may have prognostic value in multiple sclerosis.
Norgren
N
N
Department of Immunology, University of Umeå, Umeå, Sweden.
Sundström
P
P
Svenningsson
A
A
Rosengren
L
L
Stigbrand
T
T
Gunnarsson
M
M
D000328:Adult; D015415:Biomarkers / Q000134:cerebrospinal fluid; D005260:Female; D005904:Glial Fibrillary Acidic Protein / Q000134:cerebrospinal fluid*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis*; D016900:Neurofilament Proteins / Q000134:cerebrospinal fluid*; D011379:Prognosis
D015415:Biomarkers; D005904:Glial Fibrillary Acidic Protein; D016900:Neurofilament Proteins; C044882:neurofilament protein L