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Neurofilament levels are associated with blood-brain barrier integrity, lymphocyte extravasation, and risk factors following the first demyelinating event in multiple sclerosis

Uher, Tomas
Autor Uher, Tomas Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
McComb, Mason
Autor McComb, Mason Department of Pharmaceutical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
Galkin, Shery
Autor Galkin, Shery Department of Pharmaceutical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA
Srpová, Barbora
Autor Autorita ORCID Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
Oechtering, Johanna
Autor Oechtering, Johanna Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
Barro, Christian
Autor Barro, Christian Neurologic Clinic and Policlinic, Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
Tyblova, Michaela
Autor Tyblova, Michaela Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
Bergsland, Niels
Autor Bergsland, Niels Buffalo Neuroimaging Analysis Center, Department of Neurology, University at Buffalo, The State University of New York, Buffalo, NY, USA/IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
Krasensky, Jan
Autor Krasensky, Jan Department of Radiology, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
Dwyer, Michael
Autor Dwyer, Michael Buffalo Neuroimaging Analysis Center, Department of Neurology, University at Buffalo, The State University of New York, Buffalo, NY, USA

Multiple sclerosis. 2021 ; 27 (2) : 220-231. [pub] 20200407

Mult Scler
ISSN 1477-0970
Medvik
Zdroj

BACKGROUND: Increased blood brain barrier (BBB) permeability, CNS inflammation and neuroaxonal damage are pathological hallmarks in early multiple sclerosis (MS). OBJECTIVE: To investigate the associations of neurofilament light chain (NfL) levels with measures of BBB integrity and central nervous system (CNS) inflammation in MS during the first demyelinating event. METHODS: Blood and cerebrospinal fluid (CSF) were obtained from 142 MS (McDonald 2017) treatment-naive patients from the SET study (63% female; age: 29.7 ± 7.9 years) following the disease onset. NfL, albumin, immunoglobulin G (IgG), and immunoglobulin M (IgM) levels were measured in CSF and blood samples. Albumin quotient was computed as a marker of BBB integrity. Immune cell subset counts in CSF were measured using flow cytometry. MS risk factors, such as Human leukocyte antigen DRB1 locus gene (HLA DRB1)*1501, anti-Epstein-Barr virus (EBV) antibodies, and 25-hydroxy vitamin D3, were also measured. RESULTS: Higher serum NfL (sNfL) levels were associated with higher albumin quotient (p < 0.001), CSF CD80+ (p = 0.012), and CD80+ CD19+ (p = 0.015) cell frequency. sNfL levels were also associated with contrast-enhancing and T2 lesions on brain magnetic resonance imaging (MRI; all p ⩽ 0.001). Albumin quotient was not associated with any of the MS risk factors assessed. sNfL levels were associated with anti-EBV viral capsid antigen (VCA) IgG levels (p = 0.0026). CONCLUSION: sNfL levels during the first demyelinating event of MS are associated with greater impairment of BBB integrity, immune cell extravasation, and brain lesion activity on MRI.

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