PDF(Pubmed)
Abstract：
OBJECTIVE: Serum neurofilament light chain (sNfL), an indicator of neuronal damage, is increasingly recognized as a potential biomarker for disease activity in neurodegenerative disorders. In this study, we wanted to investigate sNfL as a prognostic marker in a large, well-defined population of 90 patients with Lyme neuroborreliosis (LNB). In addition, we sought to explore associations between symptoms and sNfL levels during the acute phase of LNB.
METHODS: Patients diagnosed with definite or possible LNB were recruited from a double-blinded, placebo-controlled, multi-center trial, in which the participants were randomly assigned to 2 or 6 weeks of oral doxycycline treatment. The sNfL levels were measured using a single molecule array assay at both diagnosis and 6-month follow-up, and analysed against clinical parameters, variations in symptom burden and long-term complaints as assessed by a composite clinical score.
RESULTS: At the time of diagnosis, approximately 60% of the patients had elevated sNfL levels adjusted for age. Notably, mean sNfL levels were significantly higher at diagnosis (52 pg/ml) compared to 6 months after treatment (12 pg/ml, p < 0.001), when sNfL levels had normalized in the majority of patients. Patients with objective signs of spinal radiculitis had significantly higher baseline sNfL levels compared to patients without spinal radiculitis (p = 0.033).
CONCLUSIONS: Our findings suggest that sNfL can serve as a biomarker for peripheral nerve tissue involvement in the acute phase of LNB. As found in an earlier study, we confirm normalization of sNfL levels in blood after treatment. We found no prognostic value of acute-phase sNfL levels on patient outcome.
METHODS: Patients diagnosed with definite or possible LNB were recruited from a double-blinded, placebo-controlled, multi-center trial, in which the participants were randomly assigned to 2 or 6 weeks of oral doxycycline treatment. The sNfL levels were measured using a single molecule array assay at both diagnosis and 6-month follow-up, and analysed against clinical parameters, variations in symptom burden and long-term complaints as assessed by a composite clinical score.
RESULTS: At the time of diagnosis, approximately 60% of the patients had elevated sNfL levels adjusted for age. Notably, mean sNfL levels were significantly higher at diagnosis (52 pg/ml) compared to 6 months after treatment (12 pg/ml, p < 0.001), when sNfL levels had normalized in the majority of patients. Patients with objective signs of spinal radiculitis had significantly higher baseline sNfL levels compared to patients without spinal radiculitis (p = 0.033).
CONCLUSIONS: Our findings suggest that sNfL can serve as a biomarker for peripheral nerve tissue involvement in the acute phase of LNB. As found in an earlier study, we confirm normalization of sNfL levels in blood after treatment. We found no prognostic value of acute-phase sNfL levels on patient outcome.
摘要：
目的：血清神经丝轻链（sNfL），神经元损伤的指标，越来越被认为是神经退行性疾病中疾病活动的潜在生物标志物。在这项研究中,我们想研究sNfL作为一个预后标志物，明确定义的90例莱姆病神经性贝类（LNB）患者。此外,我们试图探索LNB急性期症状与sNfL水平之间的关联.
方法：诊断为明确或可能的LNB的患者从双盲，安慰剂对照,多中心试验,其中参与者被随机分配至口服多西环素治疗2周或6周.在诊断和6个月随访时使用单分子阵列测定法测量sNfL水平，并根据临床参数进行分析，通过综合临床评分评估的症状负担和长期主诉的变化。
结果：在诊断时，约60%的患者根据年龄调整后sNfL水平升高.值得注意的是,诊断时的平均sNfL水平(52pg/ml)显著高于治疗后6个月(12pg/ml,p<0.001)，当大多数患者的sNfL水平恢复正常时。与没有脊髓神经根炎的患者相比，具有脊髓神经根炎客观体征的患者的基线sNfL水平明显更高（p=0.033）。
结论：我们的研究结果表明sNfL可以作为LNB急性期周围神经组织受累的生物标志物。正如在早期的研究中发现的那样，我们证实治疗后血液中sNfL水平正常化。我们发现急性期sNfL水平对患者预后无预后价值。
方法：诊断为明确或可能的LNB的患者从双盲，安慰剂对照,多中心试验,其中参与者被随机分配至口服多西环素治疗2周或6周.在诊断和6个月随访时使用单分子阵列测定法测量sNfL水平，并根据临床参数进行分析，通过综合临床评分评估的症状负担和长期主诉的变化。
结果：在诊断时，约60%的患者根据年龄调整后sNfL水平升高.值得注意的是,诊断时的平均sNfL水平(52pg/ml)显著高于治疗后6个月(12pg/ml,p<0.001)，当大多数患者的sNfL水平恢复正常时。与没有脊髓神经根炎的患者相比，具有脊髓神经根炎客观体征的患者的基线sNfL水平明显更高（p=0.033）。
结论：我们的研究结果表明sNfL可以作为LNB急性期周围神经组织受累的生物标志物。正如在早期的研究中发现的那样，我们证实治疗后血液中sNfL水平正常化。我们发现急性期sNfL水平对患者预后无预后价值。
