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Serum GFAP and NfL levels in benign relapsing-remitting multiple sclerosis
Marja Niiranen1, Aleksi Kontkanen2, Olli Jääskeläinen2
1Neuro Center, Neurology Outpatient Clinic, Kuopio University Hospital, P.O. BOX 100, Kuopio FI-70029, Finland.
Multiple Sclerosis and Related Disorders
|October 9, 2021
Summary
Serum glial fibrillary acidic protein (GFAP) levels are elevated in both benign and aggressive forms of relapsing-remitting multiple sclerosis (MS) compared to controls. Neurofilament light chain (NfL) levels did not differentiate between MS subtypes, suggesting GFAP may indicate astrocytic activation in MS.
Area of Science:
- Neuroscience
- Biomarker Discovery
- Immunology
Background:
- Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
- Differentiating between benign relapsing-remitting MS (BRRMS) and aggressive relapsing-remitting MS (ARRMS) is crucial for treatment strategies.
- Serum biomarkers like glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) are being investigated for their diagnostic and prognostic potential in MS.
Purpose of the Study:
- To evaluate serum GFAP and NfL as potential biomarkers to distinguish between BRRMS and ARRMS.
- To assess GFAP and NfL levels in patients with different MS subtypes and healthy controls.
- To explore the relationship between GFAP levels and disease-modifying treatment (DMT) use in BRRMS.
Main Methods:
- Serum samples were collected from patients with BRRMS (n=34), ARRMS (n=29), and healthy controls (n=14).
- Serum GFAP and NfL concentrations were measured using Single Molecule Array (Simoa) technology.
- Patients with ARRMS were on highly effective DMTs (fingolimod or natalizumab).
Main Results:
- Serum GFAP levels were significantly elevated in both BRRMS and ARRMS patients compared to healthy controls (p=0.035 and p=0.034, respectively).
- No significant difference in serum GFAP levels was observed between BRRMS and ARRMS.
- Serum NfL levels did not differ significantly among BRRMS, ARRMS, and healthy controls.
- GFAP levels were higher in BRRMS patients not on DMT compared to those on DMT (p=0.04).
Conclusions:
- Elevated serum GFAP in both BRRMS and ARRMS suggests astrocytic activation.
- Serum NfL levels do not differentiate between BRRMS and ARRMS, potentially due to stable disease phases and effective DMT use in ARRMS.
- Single measurements of serum NfL and GFAP are insufficient to distinguish between BRRMS and effectively treated ARRMS; longitudinal sampling is recommended for follow-up.
