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Neurofilament light chain in cerebrospinal fluid and prediction of disease activity in clinically isolated syndrome and relapsing–remitting multiple sclerosis
Author(s) -
Håkansson I.,
Tisell A.,
Cassel P.,
Blennow K.,
Zetterberg H.,
Lundberg P.,
Dahle C.,
Vrethem M.,
Ernerudh J.
Publication year - 2017
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13274
Subject(s) - medicine , clinically isolated syndrome , cerebrospinal fluid , biomarker , multiple sclerosis , surrogate endpoint , gastroenterology , disease , pathology , oncology , immunology , biochemistry , chemistry
Background and purpose Improved biomarkers are needed to facilitate clinical decision‐making and as surrogate endpoints in clinical trials in multiple sclerosis (MS). We assessed whether neurodegenerative and neuroinflammatory markers in cerebrospinal fluid (CSF) at initial sampling could predict disease activity during 2 years of follow‐up in patients with clinically isolated syndrome (CIS) and relapsing–remitting MS. Methods Using multiplex bead array and enzyme‐linked immunosorbent assay, CXCL 1, CXCL 8, CXCL 10, CXCL 13, CCL 20, CCL 22, neurofilament light chain (NFL), neurofilament heavy chain, glial fibrillary acidic protein, chitinase‐3‐like‐1, matrix metalloproteinase‐9 and osteopontin were analysed in CSF from 41 patients with CIS or relapsing–remitting MS and 22 healthy controls. Disease activity (relapses, magnetic resonance imaging activity or disability worsening) in patients was recorded during 2 years of follow‐up in this prospective longitudinal cohort study. Results In a logistic regression analysis model, NFL in CSF at baseline emerged as the best predictive marker, correctly classifying 93% of patients who showed evidence of disease activity during 2 years of follow‐up and 67% of patients who did not, with an overall proportion of 85% (33 of 39 patients) correctly classified. Combining NFL with either neurofilament heavy chain or osteopontin resulted in 87% overall correctly classified patients, whereas combining NFL with a chemokine did not improve results. Conclusions This study demonstrates the potential prognostic value of NFL in baseline CSF in CIS and relapsing–remitting MS and supports its use as a predictive biomarker of disease activity.