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The Use of Serum Glial Fibrillary Acidic Protein Measurements in the Diagnosis of Neuromyelitis Optica Spectrum Optic Neuritis

Storoni, M; Petzold, A; Plant, GT; (2011) The Use of Serum Glial Fibrillary Acidic Protein Measurements in the Diagnosis of Neuromyelitis Optica Spectrum Optic Neuritis. PLoS ONE , 6 (8) , Article e23489. 10.1371/journal.pone.0023489. Green open access

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Abstract

Background: Glial fibrillary acidic protein (GFAP) is a specific intermediate filament of the cytoskeleton of the astrocyte and may be used as a specific marker for astrocytic damage. It is detectable in the cerebrospinal fluid following a relapse caused by Multiple Sclerosis (MS) and Neuromyelitis Optica (NMO) spectrum disease. Higher levels are found following an NMO-related relapse. It is not known if GFAP is also detectable in the serum following such relapses. In particular, it is not known if lesions limited to the optic nerve release GFAP in sufficient quantities to be detectable within the serum. The aim of this study was to ascertain the extent to which serum GFAP levels can distinguish between an episode of optic neuritis (ON) related to NMO spectrum disease and ON from other causes.Methodology/Principal Findings: Out of 150 patients consecutively presenting to our eye hospital over the period March 2009 until July 2010, we were able to collect a serum sample from 12 patients who had presented with MS-related ON and from 10 patients who had presented with NMO spectrum disease-related ON. We also identified 8 patients with recurrent isolated ON and 8 patients with a corticosteroid-dependent optic neuropathy in the absence of any identified aetiology. GFAP was detectable in the serum of all but three patients (two patients with MS-related ON and one with recurrent optic neuritis). The median serum GFAP level in the patient group with NMO spectrum disease was 4.63 pg/mL whereas in all other cases combined together, this was 2.14 pg/mL. The difference was statistically significant (P = 0.01). A similar statistically significant difference was found when cases with pathology limited to the optic nerve were compared (P = 0.03).Conclusions: Glial pathology in NMO related optic neuritis is reflected in elevated serum GFAP levels independently of whether or not there is extra-optic nerve disease.

Type: Article
Title: The Use of Serum Glial Fibrillary Acidic Protein Measurements in the Diagnosis of Neuromyelitis Optica Spectrum Optic Neuritis
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0023489
Publisher version: http://dx.doi.org/10.1371/journal.pone.0023489
Language: English
Additional information: © 2011 Storoni et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: MULTIPLE-SCLEROSIS, ASTROCYTIC DAMAGE, TREATMENT TRIAL, NEUROPATHY, CRITERIA, MARKER, NMO
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
URI: https://discovery.ucl.ac.uk/id/eprint/1327911
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