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- Title
The potential of serum neurofilament as biomarker for multiple sclerosis.
- Authors
Bittner, Stefan; Oh, Jiwon; Havrdová, Eva Kubala; Tintoré, Mar; Zipp, Frauke
- Abstract
Multiple sclerosis is a highly heterogeneous disease, and the detection of neuroaxonal damage as well as its quantification is a critical step for patients. Blood-based serum neurofilament light chain (sNfL) is currently under close investigation as an easily accessible biomarker of prognosis and treatment response in patients with multiple sclerosis. There is abundant evidence that sNfL levels reflect ongoing inflammatory-driven neuroaxonal damage (e.g. relapses or MRI disease activity) and that sNfL levels predict disease activity over the next few years. In contrast, the association of sNfL with long-term clinical outcomes or its ability to reflect slow, diffuse neurodegenerative damage in multiple sclerosis is less clear. However, early results from real-world cohorts and clinical trials using sNfL as a marker of treatment response in multiple sclerosis are encouraging. Importantly, clinical algorithms should now be developed that incorporate the routine use of sNfL to guide individualized clinical decision-making in people with multiple sclerosis, together with additional fluid biomarkers and clinical and MRI measures. Here, we propose specific clinical scenarios where implementing sNfL measures may be of utility, including, among others: initial diagnosis, first treatment choice, surveillance of subclinical disease activity and guidance of therapy selection.
- Subjects
MULTIPLE sclerosis; BIOMARKERS; CYTOPLASMIC filaments; TREATMENT effectiveness; MEDICAL protocols; NEUROMYELITIS optica; RESEARCH; NERVE tissue proteins; RESEARCH methodology; MAGNETIC resonance imaging; PROGNOSIS; MEDICAL cooperation; EVALUATION research; COMPARATIVE studies; LONGITUDINAL method
- Publication
Brain: A Journal of Neurology, 2021, Vol 144, Issue 10, p2954
- ISSN
0006-8950
- Publication type
journal article
- DOI
10.1093/brain/awab241