New method to predict disability progression in secondary progressive multiple sclerosis

A new study has found that high blood levels of the proteins neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) can indicate an increased risk of worsening disability in people with secondary progressive multiple sclerosis (SPMS).

NfL is released into the blood when cells in the nervous system are damaged, so the presence of high levels indicate nervous system damage. The other protein is associated with the activity of astrocytes, which are neural support cells, and its presence is also a marker of injury to the nervous system. Both proteins have been studied and found to have significance for prognosis in MS previously, but this new research found that they can provide additional useful information when combined.

Participants with non-active SPMS who had high levels of both proteins had significantly worse disability-related outcomes than those that had low levels of both.

High levels of NfL, but not of GFAP, were also linked to quicker worsening disability, when compared with lower levels of both proteins. When levels of GFAP were high, but NfL levels were low, this was not significantly associated with disability progression.

Researchers said while all of these results related to people with non-active SPMS, in contrast, levels of these proteins showed no consistent trends across disability outcomes.

The findings were presented at the 2021 annual meeting of the American Academy of Neurology.