Cerebrospinal fluid neurofilament light chain in multiple sclerosis and its subtypes: a meta-analysis of case-control studies.

Szczegóły
Abstrakt

Tytuł:: Cerebrospinal fluid neurofilament light chain in multiple sclerosis and its subtypes: a meta-analysis of case-control studies.
Autorzy:: Martin SJ; Anne Rowling Centre for Regenerative Neurology, University of Edinburgh, Edinburgh, UK .; University of Glasgow, Glasgow, UK.
McGlasson S; MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK.; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Hunt D; MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK.; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Overell J; University of Glasgow, Glasgow, UK.; Glasgow Multiple Sclerosis Clinical Research Centre, Queen Elizabeth University Hospital, Glasgow, UK.
Źródło:: Journal of neurology, neurosurgery, and psychiatry [J Neurol Neurosurg Psychiatry] 2019 Sep; Vol. 90 (9), pp. 1059-1067. Date of Electronic Publication: 2019 May 23.
Typ publikacji:: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Systematic Review
Język:: English
Imprint Name(s):: Publication: London : BMJ Publishing Group
Original Publication: London : British Medical Association
MeSH Terms:: Multiple Sclerosis/*cerebrospinal fluid
Neurofilament Proteins/*cerebrospinal fluid
Case-Control Studies ; Humans ; Multiple Sclerosis/diagnosis ; Multiple Sclerosis, Chronic Progressive/cerebrospinal fluid ; Multiple Sclerosis, Chronic Progressive/diagnosis ; Multiple Sclerosis, Relapsing-Remitting/cerebrospinal fluid ; Multiple Sclerosis, Relapsing-Remitting/diagnosis ; Severity of Illness Index
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Grant Information:: United Kingdom WT_ Wellcome Trust; MRF_MRF-159-0001-ELP-HUNT United Kingdom MRF MRF
Contributed Indexing:: Keywords: CSF; multiple sclerosis; neuroimmunology
Substance Nomenclature:: 0 (Neurofilament Proteins)
0 (neurofilament protein L)
Entry Date(s):: Date Created: 20190525 Date Completed: 20200506 Latest Revision: 20220720
Update Code:: 20240104
PubMed Central ID:: PMC6820150
DOI:: 10.1136/jnnp-2018-319190
PMID:: 31123141
: Czasopismo naukowe

Objective: Neurofilament is a biomarker of axonal injury proposed as a useful adjunct in the monitoring of patients with multiple sclerosis (MS). We conducted a systematic review and meta-analysis of case-control studies that have measured neurofilament light chain (NfL) levels in cerebrospinal fluid (CSF) of people with MS (pwMS), in order to determine whether, and to what degree, CSF NfL levels differentiate MS from controls, or the subtypes or stages of MS from each other.
Methods: Guidelines on Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed. Electronic databases were searched for published and 'grey' literature, with 151 hits. Of 51 full articles screened, 20 were included in qualitative analysis, and 14 in meta-analysis.
Results: CSF NfL was higher in 746 pwMS than 435 (healthy and disease) controls, with a moderate effect size of 0.61 (p < 0.00001). Mean CSF NfL levels were significantly higher in 176 pwMS with relapsing disease than 92 with progressive disease (2124.8 ng/L, SD 3348.9 vs 1121.4 ng/L, SD 947.7, p = 0.0108). CSF NfL in 138 pwMS in relapse (irrespective of MS subtype) was double that seen in 268 pwMS in remission (3080.6 ng/L, SD 4715.9 vs 1541.7 ng/L, SD 2406.5, p < 0.0001).
Conclusions: CSF NfL correlates with MS activity throughout the course of MS, reflecting the axonal damage in pwMS. Relapse is more strongly associated with elevated CSF NfL levels than the development of progression, and NfL may be most useful as a marker of disease 'activity' rather than as a marker of disability or disease stage.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.)

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