Abstract：
Neurofilament light protein (NfL) is a part of the neuronal skeleton, primarily expressed in axons, and is released when nerves are damaged. NfL has been found to be a potential diagnostic biomarker in different types of polyneuropathies. However, whether NfL levels can be used as a predictor for the risk of disease progression is currently less understood. We searched MEDLINE (PubMed), Embase, Cochrane Library, and Web of Science Searches and included longitudinal studies with a baseline and follow-up examination of adult patients with polyneuropathy and NfL measured in blood. Twenty studies investigating NfL as a predictor of disease progression were identified, examining eight polyneuropathy subtypes. The results from studies in Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) patients were divergent, with two out of five studies finding a significant association between NfL levels and clinical outcomes. Meta-analysis of the three Guillian-Barré Syndrome (GBS) studies found higher odds for the inability to run after 1 year in patients with high levels of NfL (odds ratio 2.18, 95% confidence interval 1.04-4.56). Results from studies examining other subacute or chronic polyneuropathies like Charcot-Marie-Tooth (CMT) varied in study design and results. Our findings suggest NfL can be used as a predictor of disease progression, particularly in polyneuropathies such as CIDP and GBS. However, NfL may not serve as a reliable and cost-effective biomarker for slowly progressive polyneuropathies like CMT. Future standardized studies considering NfL as a prognostic blood biomarker in patients with different types of polyneuropathies are warranted.
摘要：
目的：神经丝光蛋白（NfL）是神经元骨骼的一部分，主要在轴突中表达，并在神经受损时释放。已发现NfL是不同类型的多发性神经病中的潜在诊断生物标志物。然而,NfL水平是否可作为疾病进展风险的预测指标目前尚不清楚.
方法：我们搜索了MEDLINE（PubMed），Embase,科克伦图书馆,和WebofScience搜索并包括对患有多发性神经病和血液中NfL的成年患者进行基线和随访检查的纵向研究。
结果：确定了20项调查NfL作为疾病进展预测因子的研究，检查八种多发性神经病亚型。慢性炎症性脱髓鞘性多发性神经病（CIDP）患者的研究结果不同，5项研究中有2项发现NfL水平与临床结局之间存在统计学显著关联。三项Guillian-Barré综合征（GBS）研究的荟萃分析发现，NfL水平高的患者在一年后无法运行的几率更高（OR2.18，95％CI1.04-4.56）。检查其他亚急性或慢性多发性神经病如Charcot-Marie-Tooth（CMT）的研究结果在研究设计和结果上有所不同。
结论：我们的发现表明NfL可以用作疾病进展的预测因子，特别是在多发性神经病中，如CIDP和GBS。然而,NfL可能不能作为CMT等缓慢进行性多发性神经病的可靠且具有成本效益的生物标志物。未来的标准化研究将NfL作为不同类型多发性神经病患者的预后血液生物标志物是必要的。
方法：我们搜索了MEDLINE（PubMed），Embase,科克伦图书馆,和WebofScience搜索并包括对患有多发性神经病和血液中NfL的成年患者进行基线和随访检查的纵向研究。
结果：确定了20项调查NfL作为疾病进展预测因子的研究，检查八种多发性神经病亚型。慢性炎症性脱髓鞘性多发性神经病（CIDP）患者的研究结果不同，5项研究中有2项发现NfL水平与临床结局之间存在统计学显著关联。三项Guillian-Barré综合征（GBS）研究的荟萃分析发现，NfL水平高的患者在一年后无法运行的几率更高（OR2.18，95％CI1.04-4.56）。检查其他亚急性或慢性多发性神经病如Charcot-Marie-Tooth（CMT）的研究结果在研究设计和结果上有所不同。
结论：我们的发现表明NfL可以用作疾病进展的预测因子，特别是在多发性神经病中，如CIDP和GBS。然而,NfL可能不能作为CMT等缓慢进行性多发性神经病的可靠且具有成本效益的生物标志物。未来的标准化研究将NfL作为不同类型多发性神经病患者的预后血液生物标志物是必要的。
