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Published on: October 20, 2016
Comparative diagnostic utility of cerebrospinal fluid biomarkers in multiple sclerosis
Basant Rashad1, Sohair K Sayed1, Tarek A Rageh2
1Clinical Pathology Department, Faculty of Medicine, Assiut University, Egypt.
Background:
Multiple sclerosis (MS) diagnosis depends on clinical and magnetic resonance imaging (MRI) data; the need for confirmatory cerebrospinal fluid (CSF) biomarkers for differential diagnosis is a crucial step.
Objective:
We aim to investigate and compare the diagnostic value of CSF markers (e.g., chitinase 3-like 1 (CHI3L1), neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP)) compared to the established supportive diagnostic oligoclonal bands test (OCBs) in MS.
Methods:
We collected 62 CSF samples from suspected MS patients with T2-Hyperintense lesions and investigated OCBs and enzyme-linked immunosorbent assay (ELISA) for NfL, CHI3L1, and GFAP.
Results:
The CSF levels of NfL (p < 0.001) and CHI3L1 (p < 0.001) were significantly elevated in the MS group compared to the non-MS group, in contrast to GFAP (p = 0.17). Diagnostic criteria for MS diagnosis was excellent for OCBs (Area under curve (AUC) = 0.978, p < 0.001; 95% Confidence Interval (CI): 0.929-1.000), good for CHI3L1 (AUC = 0.838, p < 0.001; 95% CI: 0.738-0.939), acceptable for NfL (AUC = 0.729, p = 0.003; 95% CI: 0.602-0.855) and poor for GFAP (AUC = 0.604, p = 0.173; 95% CI: 0.477-0.762).
Conclusion:
Among the studied biomarkers, CHI3L1 showed potential as an adjunctive biomarker for discriminating MS from non-MS patients. Its diagnostic accuracy was higher than that of NfL in our cohort, but GFAP has limited diagnostic accuracy, which could restrict its use in MS diagnosis.
