12 research outputs found
Neurofilament light in plasma is a potential biomarker of central nervous system involvement in systemic lupus erythematosus
BACKGROUND:
Neuropsychiatric manifestations (NP) are common in systemic lupus erythematosus (SLE). However, the pathophysiological mechanisms are not completely understood. Neurofilament light protein (NfL) is part of the neuronal cytoskeleton. Increased NfL concentrations, reflecting neurodegeneration, is observed in cerebrospinal fluid (CSF) in several neurodegenerative and neuroinflammatory conditions. We aimed to explore if plasma NfL could serve as a biomarker for central nervous system (CNS) involvement in SLE.
METHODS:
Sixty-seven patients with SLE underwent neurological examination; 52 underwent lumbar puncture, while 62 underwent cerebral magnetic resonance imaging (MRI). We measured selected auto-antibodies and other laboratory variables postulated to have roles in NP pathophysiology in the blood and/or CSF. We used SPM12 software for MRI voxel-based morphometry.
RESULTS:
Age-adjusted linear regression analyses revealed increased plasma NfL concentrations with increasing creatinine (β = 0.01, p < 0.001) and Q-albumin (β = 0.07, p = 0.008). We observed higher plasma NfL concentrations in patients with a history of seizures (β = 0.57, p = 0.014), impaired motor function (β = 0.36, p = 0.008), increasing disease activity (β = 0.04, p = 0.008), and organ damage (β = 0.10, p = 0.002). Voxel-based morphometry suggested an association between increasing plasma NfL concentrations and the loss of cerebral white matter in the corpus callosum and hippocampal gray matter.
CONCLUSION:
Increased plasma NfL concentrations were associated with some abnormal neurological, cognitive, and neuroimaging findings. However, plasma NfL was also influenced by other factors, such as damage accrual, creatinine, and Q-albumin, thereby obscuring the interpretation of how plasma NfL reflects CNS involvement. Taken together, NfL in CSF seems a better marker of neuronal injury than plasma NfL in patients with SLE
Neurofilament light is a biomarker of brain involvement in lupus and primary Sjögren's syndrome
Background: To test the hypothesis that neuroflament light (NfL) in CSF is a biomarker of CNS involvement in patients with
systemic lupus erythematosus (SLE) and primary Sjögren’s syndrome (pSS), we measured NfL in CSF from 52 patients with
lupus and 54 with pSS and explored associations with clinical, structural, immunological and biochemical abnormalities.
Methods: In CSF, we measured NfL, anti-P antibodies, protein S100B and TWEAK by ELISA and anti-NR2 antibodies by
electrochemiluminescence. Anti-phospholipid antibodies and routine immunological tests were performed in blood. IgG and
albumin were measured in CSF and serum for assessment of the blood–brain barrier function (Q-albumin) and intrathecal
IgG production (IgG index). Cerebral MRI and neuropsychological testing were performed.
Results: A multivariable regression model showed that increasing CSF anti-NR2 antibody levels were associated with increasing NfL levels in patients with SLE (B 1.27, 95% CI 0.88–1.65, p<0.001). Age contributed signifcantly in the model (B
0.04, 95% CI 0.03–0.05, p<0.001). Similar fndings were observed in the pSS group. Adjusted for age and sex, no associations were found between NfL levels and any MRI data. In SLE patients, higher NfL concentrations were associated with
impairments in psychomotor speed and motor function, and in pSS with motor dysfunction. These associations remained
in multivariable regression models.
Conclusions: Increased concentration of NfL in CSF is a marker of cerebral involvement in patients with SLE and pSS, is
strongly associated with the presence of anti-NR2 antibodies, and correlates with cognitive impairment in several domain