Serum Glial Fibrillary Acidic Protein and Serum Neurofilament Light Chain in NMOSD and Multiple Sclerosis; a Systematic Review of the Literature and Meta-Analysis
Yagya Adhikari1, Sangam Shah2, Madhur Bhattarai2, Amita Paudel3, Olga Thon1, Jesse Thon1
1Department of Neurology, Cooper University Hospital, 2Institute of Medicine, Tribhuvan University, Kathmandu, Nepal, 3Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
Objective:
This review aims to compare available data on the level of serum GFAP and serum NfL between multiple sclerosis (MS), Neuromyelitis Optica Spectrum Disorder (NMOSD), and healthy controls (HCs).
Background:
There is increasing evidence of serum neurofilament light (NfL) and Glial fibrillary acidic protein (GFAP) measurements in MS and NMOSD patients and lack of a systematic review and meta-analysis to comprehensively assess the role of serum GFAP and serum NfL in MS and NMOSD.
Design/Methods:
We conducted a systematic search on electronic databases (PubMed, Cochrane Library, GoogleScholar and EMBASE) from inception to August 2024 using the keywords to identify studies that measured serum GFAP and Nfl levels in people with MS and NMOSD. Quality assessment was done using Newcastle-Ottawa Scale (NOS). Statistical analysis was done using RevMan 5.4. Random-effect model was used to pool the effect size with its 95% confidence interval (CI).
Results:
Our search yielded 905 studies. A total of 14 studies met our inclusion criteria. The standard mean difference in serum GFAP levels was 0.92 [(0.78-1.05), p <0.05] for NMOSD and 0.50 [(0.03-0.96), p=0.04] for MS, compared to healthy controls, both were statistically significant. Similarly, the standard mean difference in serum NfL levels was 0.81 [(0.67-0.96), p < 0.05] for NMOSD and 0.95 [(0.58-1.32), p < 0.05] for MS, compared to healthy controls, and both were statistically significant.
Conclusions:
Serum GFAP and NfL may be potential biomarkers for MS and NMOSD, as their values increase in the serum of patients with these conditions.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.