Contributions
Abstract: 10
Type: Educational Session
Abstract Category: N/A
Neurofilaments (Nf) play an important role in maintaining neuronal size, shape, and axonal caliber. Because Nf are exclusive products of neuronal cells, their key advantage over other biomarkers is their specificity in terms of cellular source, reflection of pathomechanism and hence signal interpretation, i.e. they are highly specific for neuronal cell damage. There is extensive data showing elevated NfL levels in CSF of MS patients. The development of highly sensitive technologies has revolutionised the field and an increasing body of evidence now indicates that CSF analysis can, at least in part, be replaced by blood analysis of this protein. There is evidence that Nf light chain (NfL) levels in blood are increased in all stages of MS, and correlate with clinical and MRI measures of ongoing disease activity and severity. Moreover, there is an accumulating body of data that NfL levels capture treatment response in MS and that they may thereby have potential to be predictive for future disease outcome.
This teaching course will present the state of the art about NfL measurements in blood, including the association with measures of MS disease activity, prognosis and treatment response. We will describe the major hurdles and how to tackle them towards clinical application. Finally, we will present instructive examples and provide guidance of how CSF and increasingly also blood NfL measurements could in future be implemented in clinical practice.
1. The evidence (J. Kuhle)
- introduction to neurofilaments and single molecule array assay technology
- summary of published data on blood NfL as a measure of disease activity, prediction and treatment monitoring
2. The long road (C. Teunissen)
- reference values in controls, use beyond MS.
- quality schemes
- planning and first results of round robin and assessment of analytical validation of commonly used assays by the NfL in MS (MSNfL) working group
3. Clinical application today and tomorrow (F. Piehl)
- NfL in the context of other biomarkers of disease activity and what it does not capture
- practical implementation of NfL measurements in routine in MS
- clinical experiences by the nordic countries.
Disclosure: Jens Kuhle received speaker fees, research support, travel support, and/or served on advisory boards by ECTRIMS, Swiss MS Society, Swiss National Research Foundation, (320030_160221), University of Basel, Bayer, Biogen, Genzyme, Merck, Novartis, Protagen AG, Roche, Teva.
Abstract: 10
Type: Educational Session
Abstract Category: N/A
Neurofilaments (Nf) play an important role in maintaining neuronal size, shape, and axonal caliber. Because Nf are exclusive products of neuronal cells, their key advantage over other biomarkers is their specificity in terms of cellular source, reflection of pathomechanism and hence signal interpretation, i.e. they are highly specific for neuronal cell damage. There is extensive data showing elevated NfL levels in CSF of MS patients. The development of highly sensitive technologies has revolutionised the field and an increasing body of evidence now indicates that CSF analysis can, at least in part, be replaced by blood analysis of this protein. There is evidence that Nf light chain (NfL) levels in blood are increased in all stages of MS, and correlate with clinical and MRI measures of ongoing disease activity and severity. Moreover, there is an accumulating body of data that NfL levels capture treatment response in MS and that they may thereby have potential to be predictive for future disease outcome.
This teaching course will present the state of the art about NfL measurements in blood, including the association with measures of MS disease activity, prognosis and treatment response. We will describe the major hurdles and how to tackle them towards clinical application. Finally, we will present instructive examples and provide guidance of how CSF and increasingly also blood NfL measurements could in future be implemented in clinical practice.
1. The evidence (J. Kuhle)
- introduction to neurofilaments and single molecule array assay technology
- summary of published data on blood NfL as a measure of disease activity, prediction and treatment monitoring
2. The long road (C. Teunissen)
- reference values in controls, use beyond MS.
- quality schemes
- planning and first results of round robin and assessment of analytical validation of commonly used assays by the NfL in MS (MSNfL) working group
3. Clinical application today and tomorrow (F. Piehl)
- NfL in the context of other biomarkers of disease activity and what it does not capture
- practical implementation of NfL measurements in routine in MS
- clinical experiences by the nordic countries.
Disclosure: Jens Kuhle received speaker fees, research support, travel support, and/or served on advisory boards by ECTRIMS, Swiss MS Society, Swiss National Research Foundation, (320030_160221), University of Basel, Bayer, Biogen, Genzyme, Merck, Novartis, Protagen AG, Roche, Teva.