The role of Neurofilament light (NfL) and glial fibrillary acidic protein (GFAP) in MS and AQP4-NMOSD: Advancing clinical applications.
Sara Samadzadeh, Roy D. Sleator
Abstract
Fluid biomarkers such as Glial Fibrillary Acidic Protein (GFAP) and Neurofilament Light (NfL) play important roles in the diagnosis, monitoring, and evaluation of therapeutic responses in conditions such as Multiple Sclerosis (MS) and Aquaporin-4 Neuromyelitis Optica Spectrum Disorder (AQP4-NMOSD). These biomarkers offer key insights into the underlying pathophysiological mechanisms of these diseases, enabling effective follow-up and personalized treatment approaches, which are essential for improving patient outcomes. Herein, we synthesize the structural attributes, functional roles, and clinical significance of GFAP and NfL in the context of MS and AQP4-NMOSD. We explore the critical implications of these biomarkers in disease manifestation and progression, emphasizing the necessity to develop standardized methodologies and multicentric studies to confirm their clinical applicability. • Fluid biomarkers play an important role in the diagnosis, monitoring, and evaluation of therapeutic responses in complex neurological conditions such as MS and AQP4-NMOSD. • The structural attributes and functional roles of GFAP and NfL are considered. • The clinical applicability of GFAP and NfL, as potential biomarkers, is discussed in the context of MS and AQP4-NMOSD.