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Elevated Serum Neurofilament Light Chain Is Associated With Systemic Inflammation in Very Preterm Infants

E-V Kivivuori1, S-K Herukka2,3, S Kärkkäinen2

  • 1Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland.

Acta Paediatrica (Oslo, Norway : 1992)
|April 27, 2026
PubMed

Insights

Neurofilament light chain (NFL) levels correlate with inflammation in very preterm infants. This suggests NFL may serve as an early biomarker for brain injury, potentially guiding future interventions.

Area of Science:

  • Neonatal Neurology
  • Biomarker Research
  • Pediatric Neuroinflammation

Background:

  • Neurofilament light chain (NFL) and glial fibrillary acidic protein (GFAP) are established brain injury biomarkers in adults.
  • Their role in very preterm (VPT) infants, a population susceptible to brain injury due to inflammation and oxidative stress, is not well understood.
  • Investigating these biomarkers in VPT infants is crucial for understanding neonatal brain health.

Purpose of the Study:

  • To examine the association between serum NFL and GFAP levels and markers of inflammation and oxidative stress in very preterm infants.
  • To explore the relationship between these biomarkers and postmenstrual age (PMA) in VPT infants.
  • To determine the potential of NFL and GFAP as early indicators of brain injury in this vulnerable population.

Main Methods:

  • Prospective Finnish PreBaby study included very preterm infants.
  • Serum NFL and GFAP levels were measured at three timepoints from birth to term-equivalent age (TEA).
  • Associations were analyzed with IL-6 (inflammation marker), urinary 8-isoprostane (oxidative stress marker), and PMA.

Main Results:

  • Serum NFL levels strongly correlated with IL-6 (inflammation) (Spearman r=0.784, p<0.001).
  • Higher NFL concentrations were linked to lower PMA and decreased towards TEA.
  • Serum GFAP levels showed no association with inflammation; a weaker correlation was found between NFL and 8-isoprostane.

Conclusions:

  • Serum neurofilament light chain levels are significantly associated with inflammation in very preterm infants.
  • NFL shows potential as an early biomarker for brain injury in VPT infants.
  • Further research is warranted to explore NFL's utility in guiding preventive interventions and therapies for VPT infants.
Abstract

Keywords:
brain injuryinflammationneurofilamentoxidative stresspreterm

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