神经纤维光链的升高和残疾进展在多发性硬化症
Ahmed Abdelhak1, Pascal Benkert2,3,4, Sabine Schaedelin2,3,4
1Weill Institute for Neurosciences, Department of Neurology, University of California at San Francisco, San Francisco.
JAMA neurology
|November 6, 2023
概括
在多发性硬化症 (MS) 确认残疾恶化之前,血液神经丝光链 (NfL) 水平上升. 这一发现可能表明MS患者治疗干预的窗口.
科学领域:
- 神经科学是一个神经科学.
- 神经学 神经学
- 生物标志物 生物标志物
背景情况:
- 多发性硬化症 (MS) 中残疾累积的机制尚不清楚.
- 血液神经丝光链 (NfL) 是神经轴损伤的标志物,但其与MS中残疾进展的关联仍在争论中.
研究的目的:
- 调查NfL水平是否以及何时在MS中提升先前确认的残疾恶化 (CDW).
- 分析与复发相关 (CDW-R) 和复发独立 (CDW-NR) 的残疾恶化相关的NfL动态.
主要方法:
- 分析了两个观察队列:表达式,蛋白质组学,成像,临床 (EPIC) 和瑞士多发性硬化症队列 (SMSC).
- 包括具有可用的NfL结果的参与者,从2004-2022年提取的数据.
- 混合线性和考克斯回归模型用于评估NfL动态和与未来CDW的关联.
主要成果:
- 在两个队列中,NfLz得分在CDW-R和CDW-NR事件之前显著增加.
- 在CDW-NR事件之前,NfL升高可检测到两次访问.
- 时间到事件分析证实NfL水平预测未来的CDW-R (在1年内) 和CDW-NR (在1-2年内).
结论:
- 这项研究表明,NfL升高在MS中临床残疾恶化之前.
- 在诊断CDW之前,较高的NfL水平可能标志着活跃的中枢神经系统病理的窗口.
- 这些发现支持NfL作为MS残疾进展的潜在预测生物标志物.
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