Serum glial fibrillary acidic protein predicts disease progression in multiple sclerosis

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), fu...

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Bibliographic Details
Published in:Annals of clinical and translational neurology Vol. 11; no. 10; pp. 2719 - 2730
Main Authors: Madill, Evan, Healy, Brian C., Molazadeh, Negar, Polgar‐Turcsanyi, Mariann, Glanz, Bonnie I., Weiner, Howard L., Chitnis, Tanuja
Format: Journal Article
Language:English
Published: United States John Wiley & Sons, Inc 01.10.2024
John Wiley and Sons Inc
Wiley
Subjects:
Adult
Age
Biomarkers
Biomarkers - blood
Cerebrospinal fluid
Cognitive Dysfunction - blood
Cognitive Dysfunction - etiology
Cognitive Dysfunction - physiopathology
Disease Progression
Female
Gait
Glial Fibrillary Acidic Protein - blood
Humans
Male
Middle Aged
Multiple sclerosis
Multiple Sclerosis - blood
Multiple Sclerosis - physiopathology
Multiple Sclerosis, Chronic Progressive - blood
Multiple Sclerosis, Chronic Progressive - physiopathology
Patients
Proteins
Regression analysis
United States > US
ISSN:2328-9503, 2328-9503
Online Access:Get full text
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Summary: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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ISSN:2328-9503
2328-9503
DOI:10.1002/acn3.52187