Serum phosphorylated neurofilament-heavy chain levels in multiple sclerosis patients.


OBJECTIVES We evaluated whether the measurement of serum phosphorylated neurofilament heavy chain (pNF-H) titre is likely to be a valid biomarker of axonal injury in multiple sclerosis (MS). METHODS Serum pNF-H concentrations were measured by ELISA in cases with relapsing-remitting (RR)-MS (n=81), secondary progressive (SP) MS (n=13) and primary progressive (PP)-MS; n=6) MS; first demyelinating event (FDE; n=82); and unaffected controls (n=135). A subset of MS cases (n=45) were re-sampled on one or multiple occasions. The Multiple Sclerosis Severity Score (MSSS) and MRI measures were used to evaluate associations between serum pNF-H status, disease severity and cerebral lesion load and activity. RESULTS We confirmed the presence of pNF-H peptides in serum by ELISA. We showed that a high serum pNF-H titre was detectable in 9% of RR-MS and FDE cases, and 38.5% of SP-MS cases. Patients with a high serum pNF-H titre had higher average MSSS scores and T2 lesion volumes than patients with a low serum pNF-H titre. Repeated sampling of a subset of MS cases showed that pNF-H levels can fluctuate over time, likely reflecting temporal dynamics of axonal injury in MS. CONCLUSIONS A subset of FDE/MS cases was found to have a high serum pNF-H titre, and this was associated with changes in clinical outcome measures. We propose that routine measurement of serum pNF-H should be further investigated for monitoring axonal injury in MS.

DOI: 10.1136/jnnp-2013-306789

Cite this paper

@article{Gresle2014SerumPN, title={Serum phosphorylated neurofilament-heavy chain levels in multiple sclerosis patients.}, author={Melissa M. Gresle and Yang Liu and Laura F Dagley and J. C. Haartsen and Frederick Pearson and Anthony W Purcell and Louise Laverick and Axel Petzold and Robyn M Lucas and Anneke van der Walt and H Prime and Donald R Morris and Bruce V Taylor and Glen R. Shaw and Helmut Butzkueven}, journal={Journal of neurology, neurosurgery, and psychiatry}, year={2014}, volume={85 11}, pages={1209-13} }