Neurofilament light chain as biomarker for axonal damage in Guillain-Barré syndrome

ABSTRACTObjectiveTo study baseline serum neurofilament light chain (sNfL) levels as a prognostic biomarker in Guillain-Barré syndrome (GBS).MethodsWe measured NfL using SiMoA in serum (98 samples) and CSF (24 samples) of GBS patients prospectively included in the International GBS Outcome Study (IGOS) in Spain and compared them with controls (HC). We performed multivariable regression to analyze the association between sNfL levels and functional outcome at one year.ResultsGBS patients had higher NfL levels than HC in serum (55.49pg/mL vs 9.13pg/mL, p<0,0001) and CSF (1308.5pg/mL vs 440.24pg/mL, p=0.034). Patients with preceding diarrhea had higher sNfL than patients with respiratory symptoms or no preceding infection (134.90pg/mL vs 47.86pg/mL vs 38.02pg/mL, p=0.016). sNfL levels correlated with GDS and R-ODS scales. Patients with pure motor variant and Miller- Fisher syndrome showed higher sNfL levels than patients with sensory-motor GBS (162.18pg/mL vs 95.50pg/mL vs 38.02pg/mL; p=0.025). AMAN patients had higher sNfL levels than other variants (190.55pg/mL vs 46.79pg/mL, p=0.013). sNfL returned to normal levels at one year. High baseline sNfL levels were associated with inability to run (OR=1.65, 95% CI 1.14-2.40, p=0.009) and lower R-ODS (β −2.60, 95% β −4.66-(−0.54), p=0.014) at one year. Cut-off points predicting clinically relevant outcomes at one year with high specificity were calculated: inability to walk independently (>319pg/mL), inability to run (>248pg/mL) and ability to run (<34pg/mL).ConclusionBaseline sNfL levels are increased in patients with GBS, they are associated with disease severity and axonal variants and they have an independent prognostic value in GBS patients.

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Ratio and index of Neurofilament light chain indicate its origin in Guillain‐Barré Syndrome

Annals of Clinical and Translational Neurology ◽

10.1002/acn3.51207 ◽

2020 ◽

Vol 7 (11) ◽

pp. 2213-2220

Author(s):

Peter Körtvelyessy ◽

Jens Kuhle ◽

Emrah Düzel ◽

Stefan Vielhaber ◽

Christian Schmidt ◽

...

Keyword(s):

Light Chain ◽

Guillain Barre Syndrome ◽

Neurofilament Light Chain ◽

Neurofilament Light ◽

Guillain Barré Syndrome ◽

Guillain Barré

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Serum neurofilament light chain predicts long-term prognosis in Guillain-Barré syndrome patients

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2020-323899 ◽

2020 ◽

Vol 92 (1) ◽

pp. 70-77

Author(s):

Lorena Martín-Aguilar ◽

Pol Camps-Renom ◽

Cinta Lleixà ◽

Elba Pascual-Goñi ◽

Jordi Díaz-Manera ◽

...

Keyword(s):

Single Molecule ◽

Light Chain ◽

Axonal Neuropathy ◽

Guillain Barre Syndrome ◽

Neurofilament Light Chain ◽

Neurofilament Light ◽

Fisher Syndrome ◽

Baseline Serum ◽

Guillain Barré Syndrome ◽

Guillain Barré

ObjectiveTo study baseline serum neurofilament light chain (sNfL) levels as a prognostic biomarker in Guillain-Barré syndrome (GBS).MethodsWe measured NfL in serum (98 samples) and cerebrospinal fluid (CSF) (24 samples) of patients with GBS prospectively included in the International GBS Outcome Study (IGOS) in Spain using single-molecule array (SiMoA) and compared them with 53 healthy controls (HCs). We performed multivariable regression to analyse the association between sNfL levels and functional outcome at 1 year.ResultsPatients with GBS had higher NfL levels than HC in serum (55.49 pg/mL vs 9.83 pg/mL, p<0.0001) and CSF (1308.5 pg/mL vs 440.24 pg/mL, p=0.034). Patients with preceding diarrhoea had higher sNfL than patients with respiratory symptoms or no preceding infection (134.90 pg/mL vs 47.86 pg/mL vs 38.02 pg/mL, p=0.016). sNfL levels correlated with Guillain-Barré Syndrome Disability Score and Inflammatory Rasch-built Overall Disability Scale (I-RODS) at every timepoint. Patients with pure motor variant and Miller Fisher syndrome showed higher sNfL levels than patients with sensorimotor GBS (162.18 pg/mL vs 95.50 pg/mL vs 38.02 pg/mL, p=0.025). Patients with acute motor axonal neuropathy cute motor axonal neuropathy had higher sNfL levels than other variants (190.55 pg/mL vs 46.79 pg/mL, p=0.013). sNfL returned to normal levels at 1 year. High baseline sNfL levels were associated with inability to run (OR=1.65, 95% CI 1.14 to 2.40, p=0.009) and lower I-RODS (β −2.60, 95% CI −4.66 to −0.54, p=0.014) at 1 year. Cut-off points predicting clinically relevant outcomes at 1 year with high specificity were calculated: inability to walk independently (>319 pg/mL), inability to run (>248 pg/mL) and ability to run (<34 pg/mL).ConclusionBaseline sNfL levels are increased in patients with GBS, are associated with disease severity and axonal variants and have an independent prognostic value in patients with GBS.

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Guillain–Barré Syndrome in COVID-19—The Potential Role of NCAM-1 and Immunotherapy

BioMed ◽

10.3390/biomed1010006 ◽

2021 ◽

Vol 1 (1) ◽

pp. 80-92

Author(s):

Krzysztof Laudanski ◽

Aleksandra Yakhkind ◽

Mariana Restrepo ◽

Lindsay Draham ◽

Adam Edward Lang

Keyword(s):

Immune System ◽

Guillain Barre Syndrome ◽

System Response ◽

Healthy Individuals ◽

Neurofilament Light Chain ◽

Neurofilament Light ◽

Immune System Activation ◽

Guillain Barré Syndrome ◽

Acute Polyneuropathy ◽

Guillain Barré

Coronavirus disease 2019 (COVID-19) interacts with the nervous system directly and indirectly by affecting the activation of the immune system. Guillain–Barré syndrome (GBS) is triggered by an inappropriate immune system activation that overlaps with the neurotoxic mechanism of an invading pathogen. Here, we discuss the complexity of an abnormal immune system response leading to the generation of autoimmunity in the setting of acute viral infection. A 67-year-old male patient with COVID-19 developed a sensory motor acute polyneuropathy with respiratory failure. Several serum inflammatory and neurodegeneration markers were collected during hospital days 1, 3, 8, and 67 and compared to healthy individuals. Neural cell adhesion molecule 1 (NCAM-1) and neurofilament light chain (NfL) values were highly variable when compared to healthy individuals, but not to the reference COVID-19 group. We focused our attention on NCAM-1 as a possible target for antibodies directed at COVID-19 in silico.

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Serum Neurofilament Light Chain in NMOSD and Related Disorders: Comparison According to Aquaporin-4 and Myelin Oligodendrocyte Glycoprotein Antibodies Status

Multiple Sclerosis Journal - Experimental Translational and Clinical ◽

10.1177/2055217317743098 ◽

2017 ◽

Vol 3 (4) ◽

pp. 205521731774309 ◽

Cited By ~ 4

Author(s):

Mariotto S ◽

Farinazzo A ◽

Monaco S ◽

Gajofatto A ◽

Zanusso G ◽

...

Keyword(s):

Light Chain ◽

Malignant Disease ◽

Serum Levels ◽

Axonal Damage ◽

Aquaporin 4 ◽

Neurofilament Light Chain ◽

Neurofilament Light ◽

Spectrum Disorders ◽

Multiple Sclerosis Patients ◽

Demyelinating Disorders

Background Neurofilament light chain (NF-L) levels reflect axonal damage in different conditions, including demyelinating disorders. Objectives We aimed to compare serum NF-L levels in patients with aquaporin-4 antibodies (AQP4-Ab), myelin oligodendrocyte antibodies (MOG-Ab) and seronegative cases with neuromyelitis optica spectrum disorders and related disorders. Methods We analysed AQP4-Ab and MOG-Ab with cell-based assay and NF-L with ultrasensitive electrochemiluminescence immunoassay. Results Median NF-L levels were increased in 25 AQP4-Ab-positive patients (59 pg/ml) as compared with 22 MOG-Ab-positive cases (25 pg/ml), 52 seronegative patients (18 pg/ml), 25 multiple sclerosis patients (12 pg/ml) and 14 healthy controls (12 pg/ml). Conclusions Increased serum levels of NF-L in patients with AQP4-Ab or MOG-Ab might reflect an ongoing axonal damage and a more malignant disease course.

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