Higher Levels of Neurofilament Light Chain in Blood and Cerebrospinal Fluid Found in MS Patients, Supporting its Prognostic Potential

A meta-analysis of 13 case-control studies shows that the levels of the protein neurofilament light chain (NFL) are significantly higher in both the cerebrospinal fluid and blood of multiple sclerosis (MS) patients, compared to healthy controls.

This finding adds to previous evidence supporting the usefulness of NFL as a prognostic biomarker for disease progression and response to treatment, researchers said.

The study “Neurofilament light chain as a biological marker for multiple sclerosis: a meta-analysis study” was published in the journal Neuropsychiatric Disease and Treatment.

Biomarkers that detect MS early and may help predict disease activity and identify who is at higher risk of developing new lesions or flare-ups, are one of the major areas of research in MS.

Previous studies have shown that cerebrospinal fluid (CSF) — the fluid that surrounds the brain and spinal cord — or blood may carry markers that signal disease progression and activity.

NFL has been suggested as a potential disease biomarker. It is a protein exclusive of nerve cells and one of the major byproducts found in CSF and blood after nerve cells’ death.

In order to further investigate the use of NFL levels in CSF and blood as a credible marker for MS, researchers performed a systematic review of published studies in three databases — PubMed, Embase, and Web of Science.

From an initial pool of 900 studies, their meta-analysis included a total of 13 case-control articles with results from 15 studies; 10 studies measured the levels of NFL in CSF and five studies in the blood. These studies included 1,665 MS patients and 986 healthy controls.

From the pooled participants, 795 (469 MS patients and 326 healthy individuals) had their NFL levels measured in the CFS, and 1,856 (1,196 MS patients and 660 healthy volunteers) in the blood. Patients’ mean age varied from 31 to 44 years.

The data showed that the levels of NFL, either in the CSF or blood, of MS patients were significantly higher than in healthy controls.

“The findings of this meta-analysis have shown that there is elevated nervous system and peripheral blood concentrations of NFL in patients with MS. Therefore, NFL chain in CSF and blood sample can be used to discriminate the MS patients from healthy people,” the researchers wrote.

Overall, the results support NFL as a potential “prognostic biomarker to monitor disease progression, disease activity, and treatment efficacy in the future,” the team concluded.