Serum Neurofilament Light Chain Measurement in MS: Hurdles to Clinical Translation

Simon Thebault; Ronald A Booth; Carolina A Rush; Heather MacLean; Mark S Freedman

doi:10.3389/fnins.2021.654942

Serum Neurofilament Light Chain Measurement in MS: Hurdles to Clinical Translation

Front Neurosci. 2021 Mar 25:15:654942. doi: 10.3389/fnins.2021.654942. eCollection 2021.

Authors

Simon Thebault¹, Ronald A Booth², Carolina A Rush¹, Heather MacLean¹, Mark S Freedman¹

Affiliations

¹ Department of Medicine, The Ottawa Hospital Research Institute, The University of Ottawa, Ottawa, ON, Canada.
² Department of Pathology and Laboratory Medicine, The Eastern Ontario Regional Laboratory Association, The Ottawa Hospital, Ottawa Hospital Research Institute, The University of Ottawa, Ottawa, ON, Canada.

Abstract

Measurement of serum neurofilament light chain concentration (sNfL) promises to become a convenient, cost effective and meaningful adjunct for multiple sclerosis (MS) prognostication as well as monitoring disease activity in response to treatment. Despite the remarkable progress and an ever-increasing literature supporting the potential role of sNfL in MS over the last 5 years, a number of hurdles remain before this test can be integrated into routine clinical practice. In this review we highlight these hurdles, broadly classified by concerns relating to clinical validity and analytical validity. After setting out an aspirational roadmap as to how many of these issues can be overcome, we conclude by sharing our vision of the current and future role of sNfL assays in MS clinical practice.

Keywords: biomarker; blood; multiple sclerosis; neurofilament light; translation.

Publication types

Review