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Published on: September 20, 2018
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Clinical Manifestations
Débora Guerini de Souza1,2, Wyllians Vendramini Borelli1,3, Fabiano Marcio Nagel4
1Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 24, 2025
Summary
Severe critical illnesses increase astrocyte reactivity and neurodegeneration markers in ICU patients. Astrocyte reactivity correlates with mortality scores, highlighting GFAP and NfL as potential biomarkers for neuroprotection strategies.
Area of Science:
- Neuroscience
- Critical Care Medicine
- Biomarkers
Background:
- Intensive care unit (ICU) survivors face high risks of neurodegeneration and cognitive impairment post-severe illness.
- Astrocyte reactivity, a hallmark of neurodegenerative conditions, is implicated but poorly understood in this context.
Purpose of the Study:
- To investigate the impact of critical diseases on astrocyte reactivity, neurodegeneration, and cognitive function in ICU patients.
- To explore the relationship between astrocyte reactivity markers and mortality prediction scores.
Main Methods:
- Recruited ICU patients (>40 years) and healthy controls.
- Measured plasma glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) using SIMOA.
- Assessed cognitive function with Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MOCA).
Main Results:
- ICU patients exhibited significantly elevated GFAP and NfL levels compared to controls.
- GFAP levels positively correlated with Simplified Acute Physiology Score III (SAPS III), a mortality predictor.
- Cognitive scores (MMSE, MOCA) differed between groups but did not correlate with GFAP or NfL levels.
Conclusions:
- Critical illnesses significantly impact astrocyte reactivity and neurodegeneration markers.
- Astrocyte reactivity shows a link to mortality prediction in critical care settings.
- GFAP and NfL warrant further investigation as biomarkers for managing neurodegeneration in ICU survivors.
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