Serum glial fibrillary acidic protein predicts disease progression in multiple sclerosis

IF 4.4 2区 医学 Q1 CLINICAL NEUROLOGY Annals of Clinical and Translational Neurology Pub Date : 2024-09-05 DOI:10.1002/acn3.52187
Evan Madill, Brian C. Healy, Negar Molazadeh, Mariann Polgar-Turcsanyi, Bonnie I. Glanz, Howard L. Weiner, Tanuja Chitnis
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Abstract

Objective

Glial fibrillary acidic protein (GFAP) is expressed in astrocytes and may be a useful marker of non-active progressive multiple sclerosis (MS). We evaluate serum GFAP (sGFAP) in a large cohort of MS patients to determine if it predicts progression independent of relapse activity (PIRA), future gait aid, and conversion to secondary progressive disease (SPMS).

Methods

Adults with clinically isolated syndrome or any subtype of MS who were listed in the Brigham MS Center Research Database and had at least one sGFAP result were included. All clinic visits following first sample were analyzed for PIRA, future gait aid, and conversion to SPMS. Future cognitive dysfunction and fatigue were evaluated as secondary outcomes.

Results

In total, 741 patients were included (average age: 42.3, average disease duration: 3.7 years, median EDSS: 2, and median follow-up duration: 10.0 years). Of 643 patients (86.8%) without progressive disease at baseline, 15.9% developed SPMS. Among all 741, 50.5% had PIRA and 18.6% developed a gait aid requirement. sGFAP level predicted PIRA, future gait aid, and conversion to SPMS in univariable models (p < 0.001, <0.001, and 0.002). sGFAP remained predictive for PIRA and future gait aid in multivariable models in those younger than 50 (p = 0.048, 0.003). Change in sGFAP level over time was not predictive. There was no association between sGFAP and future fatigue or cognitive dysfunction.

Interpretation

sGFAP helps to predict PIRA, future gait aid, and conversion to SPMS in a large cohort of MS patients. Our data suggest that baseline levels may be more useful than the change over time.

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血清胶质纤维酸性蛋白可预测多发性硬化症的病情发展。
目的:胶质纤维酸性蛋白(GFAP)在星形胶质细胞中表达,可能是非活动性进展型多发性硬化症(MS)的有用标记物。我们对一大群多发性硬化症患者的血清 GFAP(sGFAP)进行了评估,以确定它是否能预测独立于复发活动的进展(PIRA)、未来的步态辅助以及向继发性进展性疾病(SPMS)的转化:方法:纳入布里格姆多发性硬化症中心研究数据库中的临床孤立综合征或任何亚型多发性硬化症成人患者,他们至少有一项 sGFAP 结果。对首次采样后的所有门诊就诊情况进行分析,以了解 PIRA、未来步态辅助和转为 SPMS 的情况。未来认知功能障碍和疲劳作为次要结果进行评估:共纳入了 741 名患者(平均年龄:42.3 岁,平均病程:3.7 年,ED 中位数:3.7%):3.7年,EDSS中位数:2,随访时间中位数:10.0年):10.0年)。在基线时没有进展性疾病的 643 名患者(86.8%)中,15.9% 发展为 SPMS。在单变量模型中,sGFAP水平可预测PIRA、未来的步态辅助和转为SPMS(p 解释:sGFAP有助于预测PIRA、未来的步态辅助和转为SPMS。我们的数据表明,基线水平可能比随时间的变化更有用。
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来源期刊
Annals of Clinical and Translational Neurology
Annals of Clinical and Translational Neurology Medicine-Neurology (clinical)
CiteScore
9.10
自引率
1.90%
发文量
218
审稿时长
8 weeks
期刊介绍: Annals of Clinical and Translational Neurology is a peer-reviewed journal for rapid dissemination of high-quality research related to all areas of neurology. The journal publishes original research and scholarly reviews focused on the mechanisms and treatments of diseases of the nervous system; high-impact topics in neurologic education; and other topics of interest to the clinical neuroscience community.
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