Combining CSF and Serum Biomarkers to Differentiate Mechanisms of Disability Worsening in Multiple Sclerosis

The combined use of serum and CSF biomarkers for prognostic stratification in multiple sclerosis (MS) remains underexplored. This multicenter observational study investigated associations between serum neurofilament light chain (sNfL), glial fibrillary acidic protein (sGFAP), and CSF lipid-specific...

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Autores: Monreal, Enric|||0000-0003-3293-0125, Fernández Velasco, José Ignacio|||0000-0001-9148-671X, Sainz De La Maza, Susana, Espiño, Mercedes, Villarrubia, Noelia, Roldán, Ernesto, Aladro, Yolanda|||0000-0001-9459-5452, Cuello, Juan Pablo, Ayuso-Peralta, Lucía, Rodero-Romero, Alexander, Chico-García, Juan Luís, Rodríguez-Jorge, Fernando, Quiroga-Varela, Ana, Rodríguez-Martín, Eulalia, Pilo, Belén, Martín Ávila, Guillermo, Martínez-Ginés, María Luisa, García Domínguez, José Manuel, Rubio, Lluïsa, Llufriu, Sara|||0000-0003-4273-9121, Comabella López, Manuel|||0000-0002-2373-6657, Montalban, Xavier|||0000-0002-0098-9918, Álvarez-Bravo, Gary, Veiga-Gonzalez, José Luis, Masjuan, Jaime|||0000-0003-1329-0943, Costa-Frossard, Lucienne|||0000-0002-6512-4413, Villar, Luisa M.|||0000-0002-9067-3668
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:dnet:uabarcelona_::1c578ac128f1622bcf3d008e03de1815
Acceso en línea:https://ddd.uab.cat/record/328389
https://dx.doi.org/urn:doi:10.3390/ijms26146898
Access Level:acceso abierto
Palabra clave:Multiple sclerosis
Neurofilament light chain
Glial fibrillary acidic protein
intrathecal IgM synthesis
Progression
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spelling Combining CSF and Serum Biomarkers to Differentiate Mechanisms of Disability Worsening in Multiple SclerosisMonreal, Enric|||0000-0003-3293-0125Fernández Velasco, José Ignacio|||0000-0001-9148-671XSainz De La Maza, SusanaEspiño, MercedesVillarrubia, NoeliaRoldán, ErnestoAladro, Yolanda|||0000-0001-9459-5452Cuello, Juan PabloAyuso-Peralta, LucíaRodero-Romero, AlexanderChico-García, Juan LuísRodríguez-Jorge, FernandoQuiroga-Varela, AnaRodríguez-Martín, EulaliaPilo, BelénMartín Ávila, GuillermoMartínez-Ginés, María LuisaGarcía Domínguez, José ManuelRubio, LluïsaLlufriu, Sara|||0000-0003-4273-9121Comabella López, Manuel|||0000-0002-2373-6657Montalban, Xavier|||0000-0002-0098-9918Álvarez-Bravo, GaryVeiga-Gonzalez, José LuisMasjuan, Jaime|||0000-0003-1329-0943Costa-Frossard, Lucienne|||0000-0002-6512-4413Villar, Luisa M.|||0000-0002-9067-3668Multiple sclerosisNeurofilament light chainGlial fibrillary acidic proteinintrathecal IgM synthesisProgressionThe combined use of serum and CSF biomarkers for prognostic stratification in multiple sclerosis (MS) remains underexplored. This multicenter observational study investigated associations between serum neurofilament light chain (sNfL), glial fibrillary acidic protein (sGFAP), and CSF lipid-specific IgM oligoclonal bands (LS-OCMB) with different forms of disability worsening, such as relapse-associated worsening (RAW), active progression independent of relapse activity (aPIRA), and non-active PIRA (naPIRA). A total of 535 patients with MS were included, all sampled within one year of disease onset. Biomarkers were quantified using single-molecule array and immunoblotting techniques, and CSF cell subsets were analyzed by flow cytometry. High sNfL z-scores and LS-OCMB positivity were independently associated with increased risk of RAW and aPIRA, collectively termed inflammatory-associated worsening (IAW), while elevated sGFAP levels predicted naPIRA. Patients with both high sNfL and LS-OCMB positivity had the highest risk of IAW. Among LS-OCMB-positive patients, higher regulatory T cell percentages were associated with lower sNfL levels, suggesting a protective role. Conversely, in LS-OCMB-negative patients, sNfL levels correlated with CSF C3 concentrations. These findings support the complementary role of sNfL, sGFAP, and LS-OCMB in identifying distinct mechanisms of disease worsening and may inform early personalized management strategies in MS. 22025-01-0120252025-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/328389https://dx.doi.org/urn:doi:10.3390/ijms26146898reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengInstituto de Salud Carlos III https://doi.org/10.13039/501100004587 PI21/00828Instituto de Salud Carlos III https://doi.org/10.13039/501100004587 PI24/01018Ministerio de Economía y Competitividad https://doi.org/10.13039/501100003329 RD16/0015/0001Ministerio de Economía y Competitividad https://doi.org/10.13039/501100003329 RD16/0015/0002Ministerio de Economía y Competitividad https://doi.org/10.13039/501100003329 RD16/0015/0003Ministerio de Economía y Competitividad https://doi.org/10.13039/501100003329 RD16/0015/0006open accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:dnet:uabarcelona_::1c578ac128f1622bcf3d008e03de18152026-06-06T12:50:31Z
dc.title.none.fl_str_mv Combining CSF and Serum Biomarkers to Differentiate Mechanisms of Disability Worsening in Multiple Sclerosis
title Combining CSF and Serum Biomarkers to Differentiate Mechanisms of Disability Worsening in Multiple Sclerosis
spellingShingle Combining CSF and Serum Biomarkers to Differentiate Mechanisms of Disability Worsening in Multiple Sclerosis
Monreal, Enric|||0000-0003-3293-0125
Multiple sclerosis
Neurofilament light chain
Glial fibrillary acidic protein
intrathecal IgM synthesis
Progression
title_short Combining CSF and Serum Biomarkers to Differentiate Mechanisms of Disability Worsening in Multiple Sclerosis
title_full Combining CSF and Serum Biomarkers to Differentiate Mechanisms of Disability Worsening in Multiple Sclerosis
title_fullStr Combining CSF and Serum Biomarkers to Differentiate Mechanisms of Disability Worsening in Multiple Sclerosis
title_full_unstemmed Combining CSF and Serum Biomarkers to Differentiate Mechanisms of Disability Worsening in Multiple Sclerosis
title_sort Combining CSF and Serum Biomarkers to Differentiate Mechanisms of Disability Worsening in Multiple Sclerosis
dc.creator.none.fl_str_mv Monreal, Enric|||0000-0003-3293-0125
Fernández Velasco, José Ignacio|||0000-0001-9148-671X
Sainz De La Maza, Susana
Espiño, Mercedes
Villarrubia, Noelia
Roldán, Ernesto
Aladro, Yolanda|||0000-0001-9459-5452
Cuello, Juan Pablo
Ayuso-Peralta, Lucía
Rodero-Romero, Alexander
Chico-García, Juan Luís
Rodríguez-Jorge, Fernando
Quiroga-Varela, Ana
Rodríguez-Martín, Eulalia
Pilo, Belén
Martín Ávila, Guillermo
Martínez-Ginés, María Luisa
García Domínguez, José Manuel
Rubio, Lluïsa
Llufriu, Sara|||0000-0003-4273-9121
Comabella López, Manuel|||0000-0002-2373-6657
Montalban, Xavier|||0000-0002-0098-9918
Álvarez-Bravo, Gary
Veiga-Gonzalez, José Luis
Masjuan, Jaime|||0000-0003-1329-0943
Costa-Frossard, Lucienne|||0000-0002-6512-4413
Villar, Luisa M.|||0000-0002-9067-3668
author Monreal, Enric|||0000-0003-3293-0125
author_facet Monreal, Enric|||0000-0003-3293-0125
Fernández Velasco, José Ignacio|||0000-0001-9148-671X
Sainz De La Maza, Susana
Espiño, Mercedes
Villarrubia, Noelia
Roldán, Ernesto
Aladro, Yolanda|||0000-0001-9459-5452
Cuello, Juan Pablo
Ayuso-Peralta, Lucía
Rodero-Romero, Alexander
Chico-García, Juan Luís
Rodríguez-Jorge, Fernando
Quiroga-Varela, Ana
Rodríguez-Martín, Eulalia
Pilo, Belén
Martín Ávila, Guillermo
Martínez-Ginés, María Luisa
García Domínguez, José Manuel
Rubio, Lluïsa
Llufriu, Sara|||0000-0003-4273-9121
Comabella López, Manuel|||0000-0002-2373-6657
Montalban, Xavier|||0000-0002-0098-9918
Álvarez-Bravo, Gary
Veiga-Gonzalez, José Luis
Masjuan, Jaime|||0000-0003-1329-0943
Costa-Frossard, Lucienne|||0000-0002-6512-4413
Villar, Luisa M.|||0000-0002-9067-3668
author_role author
author2 Fernández Velasco, José Ignacio|||0000-0001-9148-671X
Sainz De La Maza, Susana
Espiño, Mercedes
Villarrubia, Noelia
Roldán, Ernesto
Aladro, Yolanda|||0000-0001-9459-5452
Cuello, Juan Pablo
Ayuso-Peralta, Lucía
Rodero-Romero, Alexander
Chico-García, Juan Luís
Rodríguez-Jorge, Fernando
Quiroga-Varela, Ana
Rodríguez-Martín, Eulalia
Pilo, Belén
Martín Ávila, Guillermo
Martínez-Ginés, María Luisa
García Domínguez, José Manuel
Rubio, Lluïsa
Llufriu, Sara|||0000-0003-4273-9121
Comabella López, Manuel|||0000-0002-2373-6657
Montalban, Xavier|||0000-0002-0098-9918
Álvarez-Bravo, Gary
Veiga-Gonzalez, José Luis
Masjuan, Jaime|||0000-0003-1329-0943
Costa-Frossard, Lucienne|||0000-0002-6512-4413
Villar, Luisa M.|||0000-0002-9067-3668
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Multiple sclerosis
Neurofilament light chain
Glial fibrillary acidic protein
intrathecal IgM synthesis
Progression
topic Multiple sclerosis
Neurofilament light chain
Glial fibrillary acidic protein
intrathecal IgM synthesis
Progression
description The combined use of serum and CSF biomarkers for prognostic stratification in multiple sclerosis (MS) remains underexplored. This multicenter observational study investigated associations between serum neurofilament light chain (sNfL), glial fibrillary acidic protein (sGFAP), and CSF lipid-specific IgM oligoclonal bands (LS-OCMB) with different forms of disability worsening, such as relapse-associated worsening (RAW), active progression independent of relapse activity (aPIRA), and non-active PIRA (naPIRA). A total of 535 patients with MS were included, all sampled within one year of disease onset. Biomarkers were quantified using single-molecule array and immunoblotting techniques, and CSF cell subsets were analyzed by flow cytometry. High sNfL z-scores and LS-OCMB positivity were independently associated with increased risk of RAW and aPIRA, collectively termed inflammatory-associated worsening (IAW), while elevated sGFAP levels predicted naPIRA. Patients with both high sNfL and LS-OCMB positivity had the highest risk of IAW. Among LS-OCMB-positive patients, higher regulatory T cell percentages were associated with lower sNfL levels, suggesting a protective role. Conversely, in LS-OCMB-negative patients, sNfL levels correlated with CSF C3 concentrations. These findings support the complementary role of sNfL, sGFAP, and LS-OCMB in identifying distinct mechanisms of disease worsening and may inform early personalized management strategies in MS.
publishDate 2025
dc.date.none.fl_str_mv 2
2025-01-01
2025
2025-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/328389
https://dx.doi.org/urn:doi:10.3390/ijms26146898
url https://ddd.uab.cat/record/328389
https://dx.doi.org/urn:doi:10.3390/ijms26146898
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.relation.none.fl_str_mv Instituto de Salud Carlos III https://doi.org/10.13039/501100004587 PI21/00828
Instituto de Salud Carlos III https://doi.org/10.13039/501100004587 PI24/01018
Ministerio de Economía y Competitividad https://doi.org/10.13039/501100003329 RD16/0015/0001
Ministerio de Economía y Competitividad https://doi.org/10.13039/501100003329 RD16/0015/0002
Ministerio de Economía y Competitividad https://doi.org/10.13039/501100003329 RD16/0015/0003
Ministerio de Economía y Competitividad https://doi.org/10.13039/501100003329 RD16/0015/0006
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
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