
DOI . ORG {
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Title[redir]:
NFL is a marker of treatment response in children with SMA treated with nusinersen | Journal of Neurology
Description:
Recently, the anti-sense oligonucleotide drug nusinersen was approved for spinal muscular atrophy (SMA) and our aim was to find a response marker for this treatment. Twelve children with SMA type 1 and two copies of the SMN2 gene were included in a consecutive single-center study. The children were sampled for CSF at baseline and every time nusinersen was given intrathecally. The neuronal biomarkers NFL and tau and the glial biomarker GFAP were measured. Motor function was assessed using CHOP INTEND. Eleven similarly aged children, who were investigated to rule out neurological or infectious disease, were used as controls. Baseline levels of NFL (4598 ± 981 vs 148 ± 39, P = 0.001), tau (939 ± 159 vs 404 ± 86, P = 0.02), and GFAP (236 ± 44 vs 108 ± 26, P = 0.02) were significantly higher in SMA children than controls. Motor function improved by nusinersen treatment in median 13 points corresponding to 5.4 points per month of treatment (P = 0.001). NFL levels typically normalized ( < 380 pg/ml) between the fourth and fifth doses [− 879.5 pg/mL/dose, 95% CI (− 1243.4, − 415.6), P = 0.0001], tau levels decreased [− 112.6 pg/mL/dose, 95% CI (− 206–7, − 18.6), P = 0.01], and minor decreases in GFAP were observed [− 16.9 pg/mL/dose, 95% CI (− 22.8, − 11.2), P = 0.02] by nusinersen treatment. Improvement in motor function correlated with reduced concentrations of NFL (rho = − 0.64, P = 0.03) and tau (rho = − 0.85, P = 0.0008) but not GFAP. Nusinersen normalized the axonal damage marker NFL and correlated with motor improvement in children with SMA. NFL may, therefore, be a novel biomarker to monitor treatment response early in the disease course.
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Keywords {🔍}
treatment, sma, nfl, children, nusinersen, motor, levels, csf, article, tau, disease, age, function, study, dose, google, scholar, change, baseline, gfap, cas, pubmed, biomarker, smn, chop, intend, onset, clinical, patient, zetterberg, spinal, type, patients, marker, treated, points, protein, hospital, university, analysis, access, muscular, atrophy, effects, increased, received, olsson, blennow, gene, included,
Topics {✒️}
amyotrophic lateral sclerosis long-term rescue anna-karin kroksmark report enzyme-linked immunosorbent assays article download pdf anti-sense oligonucleotide drug spinal muscular atrophy board-certified laboratory technicians neuron-specific structural proteins lisa wahlgren & már tulinius anna-karin kroksmark cerebrospinal fluid biomarkers consecutive single-center study related subjects sma-determining gene smn clinical cerebrospinal fluid single-nucleotide base change privacy choices/manage cookies clinical neurochemistry laboratory full access queen silvia children neurofilament light protein european research council brain biomarkers solutions clinical laboratory practice swedish research council pediatric neuroinflammatory disorders swedish state support including transient headache chop intend score mixed effects modelling nf-light kit article olsson separate interaction terms cerebrospinal fluid single-center study european economic area require wheelchair assistance heavy counterpart makes intermediate axonal filaments determine axonal caliber part axonal velocity intermediate filament present facial nerve palsy regional ethics committee innotest htau kit statistical significance threshold benign medical history opsoclonus–myoclonus syndrome de vivo dc
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headline:NFL is a marker of treatment response in children with SMA treated with nusinersen
description:Recently, the anti-sense oligonucleotide drug nusinersen was approved for spinal muscular atrophy (SMA) and our aim was to find a response marker for this treatment. Twelve children with SMA type 1 and two copies of the SMN2 gene were included in a consecutive single-center study. The children were sampled for CSF at baseline and every time nusinersen was given intrathecally. The neuronal biomarkers NFL and tau and the glial biomarker GFAP were measured. Motor function was assessed using CHOP INTEND. Eleven similarly aged children, who were investigated to rule out neurological or infectious disease, were used as controls. Baseline levels of NFL (4598 ± 981 vs 148 ± 39, P = 0.001), tau (939 ± 159 vs 404 ± 86, P = 0.02), and GFAP (236 ± 44 vs 108 ± 26, P = 0.02) were significantly higher in SMA children than controls. Motor function improved by nusinersen treatment in median 13 points corresponding to 5.4 points per month of treatment (P = 0.001). NFL levels typically normalized ( < 380 pg/ml) between the fourth and fifth doses [− 879.5 pg/mL/dose, 95% CI (− 1243.4, − 415.6), P = 0.0001], tau levels decreased [− 112.6 pg/mL/dose, 95% CI (− 206–7, − 18.6), P = 0.01], and minor decreases in GFAP were observed [− 16.9 pg/mL/dose, 95% CI (− 22.8, − 11.2), P = 0.02] by nusinersen treatment. Improvement in motor function correlated with reduced concentrations of NFL (rho = − 0.64, P = 0.03) and tau (rho = − 0.85, P = 0.0008) but not GFAP. Nusinersen normalized the axonal damage marker NFL and correlated with motor improvement in children with SMA. NFL may, therefore, be a novel biomarker to monitor treatment response early in the disease course.
datePublished:2019-05-23T00:00:00Z
dateModified:2019-05-23T00:00:00Z
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SMA
Cerebrospinal fluid
Biomarkers
Neurofilament
Tau
Neurology
Neurosciences
Neuroradiology
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headline:NFL is a marker of treatment response in children with SMA treated with nusinersen
description:Recently, the anti-sense oligonucleotide drug nusinersen was approved for spinal muscular atrophy (SMA) and our aim was to find a response marker for this treatment. Twelve children with SMA type 1 and two copies of the SMN2 gene were included in a consecutive single-center study. The children were sampled for CSF at baseline and every time nusinersen was given intrathecally. The neuronal biomarkers NFL and tau and the glial biomarker GFAP were measured. Motor function was assessed using CHOP INTEND. Eleven similarly aged children, who were investigated to rule out neurological or infectious disease, were used as controls. Baseline levels of NFL (4598 ± 981 vs 148 ± 39, P = 0.001), tau (939 ± 159 vs 404 ± 86, P = 0.02), and GFAP (236 ± 44 vs 108 ± 26, P = 0.02) were significantly higher in SMA children than controls. Motor function improved by nusinersen treatment in median 13 points corresponding to 5.4 points per month of treatment (P = 0.001). NFL levels typically normalized ( < 380 pg/ml) between the fourth and fifth doses [− 879.5 pg/mL/dose, 95% CI (− 1243.4, − 415.6), P = 0.0001], tau levels decreased [− 112.6 pg/mL/dose, 95% CI (− 206–7, − 18.6), P = 0.01], and minor decreases in GFAP were observed [− 16.9 pg/mL/dose, 95% CI (− 22.8, − 11.2), P = 0.02] by nusinersen treatment. Improvement in motor function correlated with reduced concentrations of NFL (rho = − 0.64, P = 0.03) and tau (rho = − 0.85, P = 0.0008) but not GFAP. Nusinersen normalized the axonal damage marker NFL and correlated with motor improvement in children with SMA. NFL may, therefore, be a novel biomarker to monitor treatment response early in the disease course.
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Cerebrospinal fluid
Biomarkers
Neurofilament
Tau
Neurology
Neurosciences
Neuroradiology
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name:Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
type:PostalAddress
type:Organization
PostalAddress:
name:Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
name:Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
name:Queen Silvia Children’S Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
name:Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
name:Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
name:Queen Silvia Children’S Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
name:Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
name:Queen Silvia Children’S Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
name:Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
name:Queen Silvia Children’S Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
name:Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburgs, Sweden
name:Pediatric Neurology, Children’S Hospital Datteln, Witten/Herdecke University, Datteln, Germany
name:Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
name:Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
name:Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
name:Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
name:Department of Neurodegeneration, UCL Institute of Neurology, Queen Square, London, UK
name:UK Dementia Research Institute at UCL, London, UK
name:Queen Silvia Children’S Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
name:Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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