The lancet. Open call for using NFL in diagnosis and monitoring

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frodo
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The lancet. Open call for using NFL in diagnosis and monitoring

Post by frodo » Thu Jun 25, 2020 1:26 am

Neurofilament light in blood. What more is needed for clinical implementation?

https://www.thelancet.com/pdfs/journals ... 0201-2.pdf

Cerebrospinalfluid (CSF) neurofilament light (NfL) is the best established fluid biomarker for neuroaxonal injury, irrespective of the underlying cause.

It has been studied as a disease intensity marker in both relapsing-remitting and progressive multiple sclerosis(MS), and its concentration often normalises in response to successful disease-modifying treatment.

Novel ultrasensitive analytical technologies have allowed for the reliable measurement of NfL concentration in blood; virtually all findings for CSF NfL have been replicated in blood, and CSF and blood NfL concentrations show similar dynamics over time in response to acute injury and may thus be used interchangeably

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International panel on the same subject

Post by frodo » Tue Jul 21, 2020 1:29 am

Serum neurofilament light as a biomarker in progressive multiple sclerosis

https://n.neurology.org/content/early/2 ... 6.abstract

Abstract

There is an unmet need in multiple sclerosis (MS) therapy for treatments to stop progressive disability. The development of treatments may be accelerated if novel biomarkers are developed to overcome the limitations of traditional imaging outcomes revealed in early phase trials.

In January 2019, the International Progressive Multiple Sclerosis Alliance convened a standing expert panel to consider potential tissue fluid biomarkers in MS in general and in progressive MS specifically. The panel focused their attention on neurofilament light chain (NfL) in serum or plasma, examining data from both relapsing and progressive MS. Here, we report the initial conclusions of the panel and its recommendations for further research. Serum NfL (sNfL) is a plausible marker of neurodegeneration that can be measured accurately, sensitively, and reproducibly, but standard procedures for sample processing and analysis should be established.

Findings from relapsing and progressive cohorts concur and indicate that sNfL concentrations correlate with imaging and disability measures, predict the future course of the disease, and can predict response to treatment. Importantly, disease activity from active inflammation (i.e. new T2 and gadolinium-enhancing lesions) is a large contributor to sNfL, so teasing apart disease activity from the disease progression that drives insidious disability progression in progressive MS will be challenging. More data is required on the effects of age and comorbidities, as well as the relative contributions of inflammatory activity and other disease processes.

The International Progressive Multiple Sclerosis Alliance is well positioned to advance these initiatives by connecting and supporting relevant stakeholders in progressive MS.

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