Association of serum neurofilament light chain levels and neuropsychiatric manifestations in systemic lupus erythematosus

Sinah Engel, Simone Boedecker, Paul Marczynski, Stefan Bittner, Falk Steffen, Arndt Weinmann, Andreas Schwarting, Frauke Zipp, Julia Weinmann-Menke, Felix Luessi, Sinah Engel, Simone Boedecker, Paul Marczynski, Stefan Bittner, Falk Steffen, Arndt Weinmann, Andreas Schwarting, Frauke Zipp, Julia Weinmann-Menke, Felix Luessi

Abstract

Background: The aim was to evaluate the diagnostic potential of serum neurofilament light chain (sNfL) measurements in patients with neuropsychiatric systemic lupus erythematosus (NPSLE).

Methods: sNfL levels were determined by single molecule array assay in a retrospective cross-sectional cohort of 144 patients with systemic lupus erythematosus (SLE). After log-transformation of sNfL levels, mean sNfL levels were compared between NPSLE patients and SLE patients without neuropsychiatric disease using Student's t test. Furthermore, the association of different neuropsychiatric manifestations with sNfL levels was assessed using a one-way analysis of variance (ANOVA) with post hoc analysis. Associations of sNfL with clinical and laboratory parameters were assessed by correlation and multiple linear regression analysis.

Results: NPSLE patients (n = 69) had significantly higher sNfL levels than SLE patients without neuropsychiatric disease manifestations (n = 75; mean difference: 0.13, 95% CI: 0.04-0.22, p = 0.006). With regard to the category of NPSLE manifestation, mean sNfL levels were only increased in NPSLE patients with focal central nervous system (CNS) involvement (n = 45; mean difference: 0.16, 95% CI: 0.02-0.30, p = 0.019), whereas mean sNfL levels of NPSLE patients with diffuse CNS and peripheral nervous system involvement did not differ from those of SLE patients without neuropsychiatric manifestations. Age and serum creatinine concentrations were identified as relevant contributors to sNfL levels.

Conclusion: sNfL is a promising, easily accessible biomarker for neuropsychiatric involvement in SLE patients and might therefore complement the diagnostic workup of SLE patients with suspected involvement of the nervous system.

Keywords: CNS; NPSLE; biomarker; neurofilament light chain; neurolupus.

Conflict of interest statement

Conflict of interest statement: The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: SE, SB, PM, FS, and AW report no disclosures. SB has received honoraria and compensation for travel from Biogen Idec, Merck Serono, Novartis, Sanofi-Genzyme, and Roche. AS has received speaker fees and grant/research support by AbbVie, Novartis, Roche, and GSK. FZ has recently received research grants and/or consultation funds from DFG, BMBF, PMSA, MPG, Genzyme, Merck Serono, Roche, Novartis, Sanofi-Aventis, Celgene, ONO, and Octapharma. JW-M has acted as consultant to Genfit, Gilead Sciences, Intercept Pharmaceuticals, IQVIA, Madrigal, Pfizer, Novartis, Roche, and Siemens Healthineers and has received research funding from Gilead Sciences. FL received consultancy fees from Roche and support with travel cost from Teva Pharma.

© The Author(s), 2021.

Figures

Figure 1.
Figure 1.
Comparison of sNfL levels between SLE and NPLSE patients. (a) Mean log-transformed sNfL levels are higher in NPSLE patients than in SLE patients without neuropsychiatric disease manifestation. The height of the columns marks the mean, whiskers depict the standard deviation. **A significance level of p < 0.01. (b) ROC analysis for the prediction of the presence of NPSLE manifestation exhibited an AUC of 0.646 (95% CI: 0.554–0.738, p = 0.003) for sNfL levels. AUC, area under the curve; NPSLE, neuropsychiatric systemic lupus erythematosus; ROC, receiver operating characteristic; SLE, systemic lupus erythematosus; sNfL, serum neurofilament light chain.
Figure 2.
Figure 2.
Comparison of sNfL levels between SLE patients and different neuropsychiatric SLE manifestations. Mean log-transformed sNfL levels are higher in NPSLE patients with focal CNS manifestation than in SLE patients without neuropsychiatric disease manifestation. The height of the columns marks the mean, whiskers depict the standard deviation. *A significance level of p < 0.05. CNS, central nervous system; NPSLE, neuropsychiatric systemic lupus erythematosus; PNS, peripheral nervous system; SLE, systemic lupus erythematosus; sNfL, serum neurofilament light chain.

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Source: PubMed

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