Neurofilament-light chain (NfL) has emerged as one of the more promising biomarkers in multiple sclerosis. Neurofilaments are proteins expressed by axons and released into the cerebrospinal fluid, a process that is accelerated with neuroaxonal damage. It has not been determined if elevated concentrations of NfL are due to increased expression and/or release of NfL, impaired clearance of NfL by microglia, or other factors. While the current understanding of NfL is incomplete, an elevated concentration in CSF, plasma or serum, although not specific to MS, is a potentially useful biomarker of axonal damage. Read More

Chitinase-3-like 1 (CHI3L1) is a glycoprotein produced by monocytes, microglia and activated astrocytes that has been proposed as a diagnostic and prognostic biomarker of progression in MS. A recent meta-analysis of 20 studies reported that CHI3L1 levels in CSF were strongly correlated with the clinical course (Floro et al. Neurol Neuroimmunol Neuroinflamm 2022;9:e1164). Levels were higher in converting clinically isolated syndrome (CIS) vs. non-converting CIS; in MS vs. CIS or healthy controls; and in PPMS vs. RRMS. Read More