Elevated serum GFAP predicts MS-associated diffuse white matter damage

Elevated serum fibrillary acid protein (GFAP) levels have been linked to measurable microscopic damage in normal appearing white matter (NAWM) in patients with multiple sclerosis (MS), suggesting that GFAP could be used as a biomarker of pathology-related astrocytopathies in MS . according to study results published in Multiple Sclerosis and Allied Disorders.

In this study, 62 patients with MS (mean age 49.2 years) with recurrent remitting (n = 39) or secondary progressive (n = 23) disease underwent diffusion voltage imaging (DTI) and magnetic resonance imaging (MRI) blood draws for GFAP determination Single molecule array. A total of 10 healthy controls were also recruited for this study.

The study researchers determined the mean fractional anisotropy (FA) as well as mean (MD), axial (AD) and radial (RD) diffusivity within the entire NAWM in addition to 6 segmented regions of the NAWM. They used Spearman correlation analysis to assess the relationship between DTI parameters and GFAP values.

Increased GFAP levels were associated with decreased FA values ​​within the entire NAWM (P = 0.03) as well as within the frontal (P = 0.02), temporal (P = 0.041) and cingulated (P = 0.034) NAWM. In addition, increased GFAP levels were associated with increased MD and RD values ​​within the frontal NAWM (P = 0.046 for both). After adjusting for confusing variables, increased GFAP was also associated with decreased FA in frontal (P = 0.045) and cingulated NAWM (P = 0.025). The results also showed that higher GFAP was associated with more neuraxonal damage that caused disease progression.

Limitations of this study included the small sample size and the inclusion of participants from a single center.

The study’s researchers concluded that their study “supports the use of serum GFAP as a biomarker for MS disease-associated astrocytopathies and diffuse white matter damage. In the future, the simultaneous detection of a combination of biomarkers could provide important information about the various aspects of the CNS-related pathology of MS in the clinical follow-up of patients. ”


Saraste M., Bezukladova S., Matilainen M. et al. Elevated serum glial fibrillar acidic protein associated with microstructural white matter damage in multiple sclerosis: GFAP and DTI. Mult Scler Relat Disord. Published online February 1, 2021. doi: 10.1016 / j.msard.2021.102810

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