Serum Neurofilament Light Chain as a Biomarker for Disease Activity in Relapsing Remitting Multiple Sclerosis Patients

• Published in: Multiple sclerosis and related disorders 2023-12, Vol.80, p.105231, Article 105231
• Main Authors: Elmotayam, Amal Salah Eldeen, Gouda, Tarek Abdelrahman, Elsayed, Wael Mahmoud, Mohamed, Asmaa Arafa
• Format: Article
• Language: English
• ISSN: 2211-0348
• DOI: 10.1016/j.msard.2023.105231

Monitoring of disease activity remains one of the key challenge in relapsing-remitting multiple sclerosis (RRMS) patients. Upon axonal damage, neurofilaments – a major component of the neuroaxonal cytoskeleton – is released into the cerebrospinal fluid (CSF) and subsequently into the peripheral blood. Monitoring serum neurofilament light chain levels in the CSF require repeated lumbar punctures for CSF sampling which would cause more discomfort for patients. In addition, this is more time consuming compared to the use of biomarker that could be monitored by repeated blood sampling. Therefore, the serum neurofilament light chain measurements could facilitate disease activity assessments and individualized treatment The study sample was divided into two groups. Group 1 included 35 RRMS patients (12 males and 23 females), and groupf 2 included 35 age and sex-matched healthy controls. Group 1 was further subdivided into group 1a including patients during relapse (18 patients), and group 1b including patients during remission (17 patients) .All the patients in the study were subjected to clinical assessment through detailed medical and neurological history, complete general and neurological examination to record the disease characteristics such as disease duration, nature, symptoms at first presentation, age at disease onset, type of treatment, and assessment of disease disability using the expanded disability status Scale (EDSS). Laboratory routine investigation included complete blood count, liver and kidney function tests, erythrocyte sedimentation rate, C reactive protein, fasting and random blood sugar, serum-electrolyte. Levels of serum neurofilament light chain were correlated with disease activity. Clinically, these levels were higher among patients with relapse. Radiologically, a positive correlation was found between serum neurofilament light chain level and the presence of new or enlarging T2 lesions. Serum neurofilament light chain can be used as an easily applicable biomarker for acute inflammation, neuro-axonal damage and disease activity in RRMS patients.