1
|
Rasing I, Voigt S, Koemans EA, de Kort AM, van Harten TW, van Etten ES, van Zwet EW, Stoops E, Francois C, Kuiperij BH, Klijn CJM, Schreuder FHBM, van der Weerd L, van Osch MJP, van Walderveen MAA, Verbeek MM, Terwindt GM, Wermer MJH. Serum and cerebrospinal fluid neurofilament light chain and glial fibrillary acid protein levels in early and advanced stages of cerebral amyloid Angiopathy. Alzheimers Res Ther 2024; 16:86. [PMID: 38654326 PMCID: PMC11036675 DOI: 10.1186/s13195-024-01457-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/12/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Neurofilament light chain (NFL) is a biomarker for neuroaxonal damage and glial fibrillary acidic protein (GFAP) for reactive astrocytosis. Both processes occur in cerebral amyloid angiopathy (CAA), but studies investigating the potential of NFL and GFAP as markers for CAA are lacking. We aimed to investigate NFL and GFAP as biomarkers for neuroaxonal damage and astrocytosis in CAA. METHODS For this cross-sectional study serum and cerebrospinal fluid (CSF) samples were collected between 2010 and 2020 from controls, (pre)symptomatic Dutch-type hereditary (D-CAA) mutation-carriers and participants with sporadic CAA (sCAA) from two prospective CAA studies at two University hospitals in the Netherlands. NFL and GFAP levels were measured with Simoa-assays. The association between NFL and GFAP levels and age, cognitive performance (MoCA), CAA-related MRI markers (CAA-CSVD-burden) and Aβ40 and Aβ42 levels in CSF were assessed with linear regression adjusted for confounders. The control group was divided in age < 55 and ≥55 years to match the specific groups. RESULTS We included 187 participants: 28 presymptomatic D-CAA mutation-carriers (mean age 40 years), 29 symptomatic D-CAA participants (mean age 58 years), 59 sCAA participants (mean age 72 years), 33 controls < 55 years (mean age 42 years) and 38 controls ≥ 55 years (mean age 65 years). In presymptomatic D-CAA, only GFAP in CSF (7.7*103pg/mL vs. 4.4*103pg/mL in controls; P<.001) was increased compared to controls. In symptomatic D-CAA, both serum (NFL:26.2pg/mL vs. 12.5pg/mL; P=0.008, GFAP:130.8pg/mL vs. 123.4pg/mL; P=0.027) and CSF (NFL:16.8*102pg/mL vs. 7.8*102pg/mL; P=0.01 and GFAP:11.4*103pg/mL vs. 7.5*103pg/mL; P<.001) levels were higher than in controls and serum levels (NFL:26.2pg/mL vs. 6.7pg/mL; P=0.05 and GFAP:130.8pg/mL vs. 66.0pg/mL; P=0.004) were higher than in pre-symptomatic D-CAA. In sCAA, only NFL levels were increased compared to controls in both serum (25.6pg/mL vs. 12.5pg/mL; P=0.005) and CSF (20.0*102pg/mL vs 7.8*102pg/mL; P=0.008). All levels correlated with age. Serum NFL correlated with MoCA (P=0.008) and CAA-CSVD score (P<.001). NFL and GFAP in CSF correlated with Aβ42 levels (P=0.01/0.02). CONCLUSIONS GFAP level in CSF is an early biomarker for CAA and is increased years before symptom onset. NFL and GFAP levels in serum and CSF are biomarkers for advanced CAA.
Collapse
Affiliation(s)
- Ingeborg Rasing
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Sabine Voigt
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Emma A Koemans
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Anna M de Kort
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thijs W van Harten
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ellis S van Etten
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Erik W van Zwet
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Bea H Kuiperij
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Catharina J M Klijn
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Floris H B M Schreuder
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Louise van der Weerd
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Marcel M Verbeek
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marieke J H Wermer
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
2
|
Stovickova L, Hansikova H, Hanzalova J, Musova Z, Semjonov V, Stovicek P, Hadzic H, Novotna L, Simcik M, Strnad P, Serbina A, Karamazovova S, Schwabova Paulasova J, Vyhnalek M, Krsek P, Zumrova A. Exploring mitochondrial biomarkers for Friedreich's ataxia: a multifaceted approach. J Neurol 2024:10.1007/s00415-024-12223-5. [PMID: 38520521 DOI: 10.1007/s00415-024-12223-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/24/2024] [Accepted: 01/24/2024] [Indexed: 03/25/2024]
Abstract
This study presents an in-depth analysis of mitochondrial enzyme activities in Friedreich's ataxia (FA) patients, focusing on the Electron Transport Chain complexes I, II, and IV, the Krebs Cycle enzyme Citrate Synthase, and Coenzyme Q10 levels. It examines a cohort of 34 FA patients, comparing their mitochondrial enzyme activities and clinical parameters, including disease duration and cardiac markers, with those of 17 healthy controls. The findings reveal marked reductions in complexes II and, specifically, IV, highlighting mitochondrial impairment in FA. Additionally, elevated Neurofilament Light Chain levels and cardiomarkers were observed in FA patients. This research enhances our understanding of FA pathophysiology and suggests potential biomarkers for monitoring disease progression. The study underscores the need for further clinical trials to validate these findings, emphasizing the critical role of mitochondrial dysfunction in FA assessment and treatment.
Collapse
Affiliation(s)
- Lucie Stovickova
- Department of Paediatric Neurology, Second Faculty of Medicine, Charles University, Motol University Hospital, V Uvalu 84, 15006, Prague 5, Czech Republic.
- Centre of Hereditary Ataxias, Second Faculty of Medicine, An Official EFACTS Site, a Member of European Reference Network for Rare Neurological Diseases (ERN-RND), Charles University, Motol University Hospital, Prague 5, Czech Republic.
| | - Hana Hansikova
- Department of Paediatrics and Inherited Metabolic Disorders, First Medical Faculty, Charles University and General University Hospital in Prague, Prague 2, Czech Republic
| | - Jitka Hanzalova
- Department of Immunology, Second Faculty of Medicine, Charles University, Motol University Hospital, Prague 5, Czech Republic
| | - Zuzana Musova
- Department of Biology and Medical Genetics, Second Faculty of Medicine, Charles University, Motol University Hospital, Prague 5, Czech Republic
- Centre of Hereditary Ataxias, Second Faculty of Medicine, An Official EFACTS Site, a Member of European Reference Network for Rare Neurological Diseases (ERN-RND), Charles University, Motol University Hospital, Prague 5, Czech Republic
| | - Valerij Semjonov
- Department of Paediatrics, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | | | - Haris Hadzic
- Second Faculty of Medicine, Charles University, Prague 5, Czech Republic
| | - Ludmila Novotna
- Second Faculty of Medicine, Charles University, Prague 5, Czech Republic
| | - Martin Simcik
- Second Faculty of Medicine, Charles University, Prague 5, Czech Republic
| | - Pavel Strnad
- Second Faculty of Medicine, Charles University, Prague 5, Czech Republic
| | - Anastaziia Serbina
- Second Faculty of Medicine, Charles University, Prague 5, Czech Republic
| | - Simona Karamazovova
- Department of Neurology, Second Faculty of Medicine, Charles University, Motol University Hospital, Prague 5, Czech Republic
- Centre of Hereditary Ataxias, Second Faculty of Medicine, An Official EFACTS Site, a Member of European Reference Network for Rare Neurological Diseases (ERN-RND), Charles University, Motol University Hospital, Prague 5, Czech Republic
| | - Jaroslava Schwabova Paulasova
- Department of Neurology, Second Faculty of Medicine, Charles University, Motol University Hospital, Prague 5, Czech Republic
- Centre of Hereditary Ataxias, Second Faculty of Medicine, An Official EFACTS Site, a Member of European Reference Network for Rare Neurological Diseases (ERN-RND), Charles University, Motol University Hospital, Prague 5, Czech Republic
| | - Martin Vyhnalek
- Department of Neurology, Second Faculty of Medicine, Charles University, Motol University Hospital, Prague 5, Czech Republic
- Centre of Hereditary Ataxias, Second Faculty of Medicine, An Official EFACTS Site, a Member of European Reference Network for Rare Neurological Diseases (ERN-RND), Charles University, Motol University Hospital, Prague 5, Czech Republic
| | - Pavel Krsek
- Department of Paediatric Neurology, Second Faculty of Medicine, Charles University, Motol University Hospital, V Uvalu 84, 15006, Prague 5, Czech Republic
| | - Alena Zumrova
- Department of Paediatric Neurology, Second Faculty of Medicine, Charles University, Motol University Hospital, V Uvalu 84, 15006, Prague 5, Czech Republic
- Centre of Hereditary Ataxias, Second Faculty of Medicine, An Official EFACTS Site, a Member of European Reference Network for Rare Neurological Diseases (ERN-RND), Charles University, Motol University Hospital, Prague 5, Czech Republic
| |
Collapse
|
3
|
Elkjaer ML, Lohse RM, Burton M, Mendoza JP, Thomassen M, Sejbaek T, Illes Z. Whole blood miRNAs in relapsing MS patients treated with dimethyl fumarate in the phase 4 TREMEND trial. J Neuroimmunol 2023; 381:578145. [PMID: 37393851 DOI: 10.1016/j.jneuroim.2023.578145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/20/2023] [Accepted: 06/25/2023] [Indexed: 07/04/2023]
Abstract
We investigated the impact of dimethyl fumarate (DMF), an oral therapy for relapsing multiple sclerosis (MS), on blood microRNA (miRNA) signatures and neurofilament light (NFL) levels. DMF normalized miR-660-5p and modulated various miRNAs associated with the NF-kB pathway. These alterations reached a peak 4-7 months after treatment. Notably, particular miRNAs correlated with high or low NFL levels, implying their potential role as markers of treatment efficacy. Our findings broaden the understanding of DMF's immunomodulatory effects and may aid in predicting treatment responses.
Collapse
Affiliation(s)
- Maria L Elkjaer
- Department of Neurology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, BRIDGE, University of Southern Denmark, Odense, Denmark; Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
| | - Rikke M Lohse
- Department of Neurology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, BRIDGE, University of Southern Denmark, Odense, Denmark; Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Mark Burton
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark; Clinical Genome Center, University of Southern Denmark & Region of Southern Denmark, Odense, Denmark; Human Genetics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Mads Thomassen
- Department of Clinical Research, BRIDGE, University of Southern Denmark, Odense, Denmark; Department of Clinical Genetics, Odense University Hospital, Odense, Denmark; Clinical Genome Center, University of Southern Denmark & Region of Southern Denmark, Odense, Denmark; Human Genetics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Tobias Sejbaek
- Department of Neurology, Hospital of Southwest Jutland, Esbjerg, Denmark
| | - Zsolt Illes
- Department of Neurology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, BRIDGE, University of Southern Denmark, Odense, Denmark; Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark.
| |
Collapse
|
4
|
Verde F, Milone I, Bulgarelli I, Peverelli S, Colombrita C, Maranzano A, Calcagno N, Ticozzi N, Perego GB, Parati G, Torresani E, Ratti A, Silani V. Serum neurofilament light chain levels in Covid-19 patients without major neurological manifestations. J Neurol 2022. [PMID: 35781535 DOI: 10.1007/s00415-022-11233-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 12/27/2022]
Abstract
Background Increased serum levels of neurofilament light chain (sNFL), a biomarker of neuroaxonal damage, have been reported in patients with Covid-19. We aimed at investigating whether sNFL is increased in Covid-19 patients without major neurological manifestations, is associated with disease severity, respiratory and routine blood parameters, and changes longitudinally in the short term. Methods sNFL levels were measured with single molecule array (Simoa) technology in 57 hospitalized Covid-19 patients without major neurological manifestations and in 30 neurologically healthy controls. Patients were evaluated for PaO2/FiO2 ratio on arterial blood gas, Brescia Respiratory Covid Severity Scale (BRCSS), white blood cell counts, serum C-reactive protein (CRP), plasma D-dimer, plasma fibrinogen, and serum creatinine at admission. In 20 patients, NFL was also measured on serum samples obtained at a later timepoint during the hospital stay. Results Covid-19 patients had higher baseline sNFL levels compared to controls, regardless of disease severity. Baseline sNFL correlated with serum CRP and plasma D-dimer in patients with mild disease, but was not associated with measures of respiratory impairment. Longitudinal sNFL levels tended to be higher than baseline ones, albeit not significantly, and correlated with serum CRP and plasma D-dimer. The PaO2/FiO2 ratio was not associated with longitudinal sNFL, whereas BRCSS only correlated with longitudinal sNFL variation. Conclusions We provide neurochemical evidence of subclinical axonal damage in Covid-19 also in the absence of major neurological manifestations. This is apparently not fully explained by hypoxic injury; rather, systemic inflammation might promote this damage. However, a direct neurotoxic effect of SARS-CoV-2 cannot be excluded.
Collapse
|
5
|
Williams T, Zetterberg H, Chataway J. Neurofilaments in progressive multiple sclerosis: a systematic review. J Neurol 2021; 268:3212-3222. [PMID: 32447549 PMCID: PMC8357650 DOI: 10.1007/s00415-020-09917-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Neurofilament proteins have been extensively studied in relapsing-remitting multiple sclerosis, where they are promising biomarkers of disease activity and treatment response. Their role in progressive multiple sclerosis, where there is a particularly urgent need for improved biomarkers, is less clear. The objectives of this systematic review are to summarise the literature on neurofilament light and heavy in progressive multiple sclerosis, addressing key questions. METHODS A systematic search of PubMed, Embase, Web of Science and Scopus identified 355 potential sources. 76 relevant sources were qualitatively reviewed using QUADAS-2 criteria, and 17 were identified as at low risk of bias. We summarise the findings from all relevant sources, and separately from the 17 high-quality studies. RESULTS Differences in neurofilament light between relapsing-remitting and progressive multiple sclerosis appear to be explained by differences in covariates. Neurofilament light is consistently associated with current inflammatory activity and future brain atrophy in progressive multiple sclerosis, and is consistently shown to be a marker of treatment response with immunosuppressive disease-modifying therapies. Associations with current or future disability are inconsistent, and there is no evidence of NFL being a responsive marker of purportedly neuroprotective treatments. Evidence on neurofilament heavy is more limited and inconsistent. CONCLUSIONS Neurofilament light has shown consistent utility as a biomarker of neuroinflammation, future brain atrophy and immunosuppressive treatment response at a group level. Neither neurofilament light or heavy has shown a consistent treatment response to neuroprotective disease-modifying therapies, which will require further data from successful randomised controlled trials.
Collapse
Affiliation(s)
- Thomas Williams
- Department of Neuroinflammation, Faculty of Brain Sciences, Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology, University College London, London, UK.
| | - Henrik Zetterberg
- Department of Neurodegenerative Disease, Faculty of Brain Sciences, UCL Queen Square Institute of Neurology, University College London, London, UK
- UK Dementia Research Institute, University College London, London, UK
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy At the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Jeremy Chataway
- Department of Neuroinflammation, Faculty of Brain Sciences, Queen Square Multiple Sclerosis Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
- Biomedical Research Centre, National Institute for Health Research, University College London Hospitals, London, UK
| |
Collapse
|