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Abstract：
There is debate on the role of glial fibrillary acidic protein (GFAP) as a reliable biomarker in multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD), and its potential to reflect disease progression. This review aimed to investigate the role of GFAP in MS and NMOSD. A systematic search of electronic databases, including PubMed, Embase, Scopus, and Web of Sciences, was conducted up to 20 December 2023 to identify studies that measured GFAP levels in people with MS (PwMS) and people with NMOSD (PwNMOSD). R software version 4.3.3. with the random-effect model was used to pool the effect size with its 95% confidence interval (CI). Of 4109 studies, 49 studies met our inclusion criteria encompassing 3491 PwMS, 849 PwNMOSD, and 1046 healthy controls (HCs). The analyses indicated that the cerebrospinal fluid level of GFAP (cGFAP) and serum level of GFAP (sGFAP) were significantly higher in PwMS than HCs (SMD = 0.7, 95% CI: 0.54 to 0.86, p < 0.001, I2 = 29%, and SMD = 0.54, 95% CI: 0.1 to 0.99, p = 0.02, I2 = 90%, respectively). The sGFAP was significantly higher in PwNMOSD than in HCs (SMD = 0.9, 95% CI: 0.73 to 1.07, p < 0.001, I2 = 10%). Among PwMS, the Expanded Disability Status Scale (EDSS) exhibited significant correlations with cGFAP (r = 0.43, 95% CI: 0.26 to 0.59, p < 0.001, I2 = 91%) and sGFAP (r = 0.36, 95% CI: 0.23 to 0.49, p < 0.001, I2 = 78%). Regarding that GFAP is increased in MS and NMOSD and has correlations with disease features, it can be a potential biomarker in MS and NMOSD and indicate the disease progression and disability in these disorders.
摘要：
关于胶质纤维酸性蛋白（GFAP）作为多发性硬化症（MS）和视神经脊髓炎谱系障碍（NMOSD）的可靠生物标志物的作用存在争议，以及它反映疾病进展的潜力。本文旨在探讨GFAP在MS和NMOSD中的作用。对电子数据库的系统搜索，包括PubMed,Embase,Scopus,和WebofSciences,直到2023年12月20日进行，以确定测量MS患者（PwMS）和NMOSD患者（PwNMOSD）的GFAP水平的研究。R软件版本4.3.3。使用随机效应模型将效应大小与其95%置信区间(CI)汇集在一起.在4109项研究中，49项研究符合我们的纳入标准，包括3491PwMS，849PwNMOSD,和1046名健康对照（HCs）。分析表明，PwMS的脑脊液GFAP（cGFAP）和血清GFAP（sGFAP）水平明显高于HC（SMD=0.7，95％CI：0.54至0.86，p<0.001，I2=29％，SMD=0.54，95%CI：0.1至0.99，p=0.02，I2=90%，分别)。PwNMOSD中sGFAP显著高于HC(SMD=0.9,95%CI:0.73~1.07,p<0.001,I2=10%)。在PwMS中，扩展残疾状态量表（EDSS）与cGFAP（r=0.43，95％CI：0.26至0.59，p<0.001，I2=91％）和sGFAP（r=0.36，95％CI：0.23至0.49，p<0.001，I2=78％）显着相关。关于GFAP在MS和NMOSD中增加，并与疾病特征相关，它可能是MS和NMOSD的潜在生物标志物，并指示这些疾病的疾病进展和残疾。
