Disease Biomarkers in Multiple Sclerosis: Current Serum Neurofilament Light Chain Perspectives

Abstract

The continuous neuroinflammatory and neurodegenerative pathology in multiple sclerosis (MS) results in irreversible accumulation of physical and cognitive disability. Reliable early detection of MS disease processes can aid in the diagnosis, monitoring and treatment management of MS patients. Recent assay technological advancements now allow reliable quantification of serum-based neurofilament light chain (sNfL) levels, which provide temporal information regarding the degree of neuroaxonal damage. The relationship and predictive value of sNfL with clinical and cognitive outcomes, other paraclinical measures and treatment response is reviewed. sNfL measurement is an emerging, noninvasive and disease-responsive MS biomarker that is currently utilized in research and clinical trial settings. Understanding sNfL confounders and further assay standardization will allow clinical implementation of this biomarker.

Keywords:

• clinical trials
• disability outcomes
• MRI
• multiple sclerosis
• serum neurofilament light chain

Financial & competing interests disclosure

MG Dwyer has received consultant fees from Claret Medical and EMD Serono and research grant support from Novartis. B Weinstock-Guttman received honoraria as a speaker and/or as a consultant for Biogen Idec, EMD Serono, Genentech, Novartis, Mallinckrodt, Celgene, Abbvie. B Weinstock-Guttman received research funds from Biogen Idec, EMD Serono, Genentech and Novartis. R Zivadinov received personal compensation from EMD Serono, Sanofi, Bristol Myers Squibb, Keystone Heart and Novartis for speaking and consultant fees. He received financial support for research activities from Novartis, Protembis, Bristol Myers Squibb, Keystone Heart, Mapi Pharma, V-WAVE Medical and Boston Scientific. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.