ECTRIMS 2025 | The relationship between serum biomarkers and spinal cord atrophy in MS
Alessandro Cagol, MD, University of Basel, Basel, Switzerland, shares insights into the relationship between the serum biomarkers neurofilament light chain (NFL) and glial fibrillary acid protein (GFAP) and spinal cord atrophy in multiple sclerosis (MS). Dr Cagol highlights that baseline levels of NFL and GFAP can predict spinal cord volume loss, and together these biomarkers can predict progression independent of relapse activity. This interview took place at the 41st Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in Barcelona, Spain.
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Transcript
Yes, in this poster that we presented at ECTRIMS, the goal was, first of all, to see whether blood biomarkers and specifically serum biomarkers focusing on neurofilament light chain and glial fibrillary acidic protein were able to predict the severity of spinal cord atrophy, also independently of what is the association that we already know from the literature with brain volume loss. So what we did, first of all, was to conduct a cross-sectional analysis to explore the association between spinal cord cross-sectional area and the level of serum biomarkers in our patients...
Yes, in this poster that we presented at ECTRIMS, the goal was, first of all, to see whether blood biomarkers and specifically serum biomarkers focusing on neurofilament light chain and glial fibrillary acidic protein were able to predict the severity of spinal cord atrophy, also independently of what is the association that we already know from the literature with brain volume loss. So what we did, first of all, was to conduct a cross-sectional analysis to explore the association between spinal cord cross-sectional area and the level of serum biomarkers in our patients. And we indeed find a significant association between both NFL and GFAP with the spinal cord cross-sectional area. The next step was to explore whether baseline levels of serum neurofilament light chain and GFAP are able to predict spinal cord atrophy over time. And what we saw is that indeed baseline values of these serum biomarkers are able to predict accelerated spinal cord volume loss over time. Again, also in this case, in a way that is independent from the association with the rate of brain volume loss. Therefore, meaning that indeed these biomarkers are able to predict and provide us information about the degeneration across the entire central nervous system, therefore also providing information about the spinal cord, which we know is an extremely important structure in the pathophysiology of multiple sclerosis. And the last point was to see how much serum biomarkers and the spinal cord cross-sectional area at baseline, so two different and potentially complementary biomarkers, are able to predict the future development of PIRA, which is the specific component of disability worsening that occurs independently of relapse activity. So the progression that is independent of relapse activity. And what we saw in this case is that indeed both GFAP and spinal cord cross-sectional area are indeed predictive of the future risk in our patients of accumulation of progression independent of relapse activity. So overall, the findings of this study suggest these two biomarkers as complementary in characterizing and stratifying the risk of the patients to develop progression independent of relapse activity over the follow-up. And this was conducted in the Swiss MS cohort, which is a large cohort that involved several different academic centers in Switzerland.
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