GFAP in early multiple sclerosis: A biomarker for inflammation

Area of Science:

• Neuroimmunology
• Biomarker Discovery
• Multiple Sclerosis Pathophysiology

Background:

• The diagnostic and prognostic utility of Glial Fibrillic Acidic Protein (GFAP) in multiple sclerosis (MS) remains debated.
• Understanding GFAP's role in early MS stages like clinically isolated syndrome (CIS) and relapsing-remitting multiple sclerosis (RRMS) is crucial.

Purpose of the Study:

• To investigate the value of cerebrospinal fluid (CSF) GFAP levels as a biomarker in RRMS and CIS.
• To assess the correlation between GFAP levels and MRI-defined inflammatory lesion load in these patient groups.

Main Methods:

• CSF samples from 18 RRMS patients, 8 CIS patients, and 35 controls were analyzed for GFAP concentrations.
• MRI data, including acute and chronic inflammatory lesion load, were collected and correlated with GFAP levels.

Main Results:

• CSF GFAP levels were significantly higher in patients with RRMS/CIS compared to controls (p=0.005).
• No significant difference in GFAP levels was observed between RRMS and CIS patients.
• GFAP levels strongly correlated with the intensity of gadolinium-enhancement on MRI, indicating acute inflammatory activity (p=0.0002).
• A correlation was also found between GFAP and infratentorial chronic inflammatory lesion load (p=0.0035).

Conclusions:

• GFAP serves as a valuable biomarker for detecting highly active acute inflammation in both RRMS and CIS.
• GFAP levels reflect inflammatory processes in the central nervous system in early MS stages.