neurofilament light chain (NfL) and peripheral neuropathy

Last edited 12/2022 and last reviewed 01/2023

Measurement of neurofilament light chain and peripheral neuropathy

Neurofilaments are the major cytoskeletal proteins of neurons in both the CNS and peripheral nervous system and form a lattice comprising neurofilament light (NfL), medium, and heavy (NfH) chains

• NfL
  • is a cytoskeleton protein expressed in large calibre myelinated axons
  • has a functional role in axonal growth and stability and a high expression in neuronal tissue
  • neuroaxonal damage in peripheral nerves results in the release of NfLthe extracellular space and peripheral blood, depending on the extent of damage
    
    
• has been shown that neurofilament light chain (NfL) concentration is elevated in patients with Charcot-Marie-Tooth disease (CMT) (1)
  
  
• monitoring of sNfL during chemotherapy can indicate ongoing neuroaxonal injury and the severity of oxaliplatin-induced peripheral neuropathy (OIPN) (2)
  
  
• a systematic review and meta-analysis concluded that blood-based measure of neurofilament light chain may be a useful indicator of neuronal injury in patients with peripheral neuropathy (3)

Reference:

• Sandelius A, Zetterberg H, Blennow K, Adiutori R, Malaspina A, Laura M, Reilly MM, Rossor AM. Plasma neurofilament light chain concentration in the inherited peripheral neuropathies. Neurology. 2018 Feb 6;90(6):e518-e524.
• Kim SH, Choi MK, Park NY, Hyun JW, Lee MY, Kim HJ, Jung SK, Cha Y. Serum neurofilament light chain levels as a biomarker of neuroaxonal injury and severity of oxaliplatin-induced peripheral neuropathy. Sci Rep. 2020 May 14;10(1):7995.
• Fundaun J, Kolski M, Molina-Álvarez M, Baskozos G, Schmid AB. Types and Concentrations of Blood-Based Biomarkers in Adults With Peripheral Neuropathies: A Systematic Review and Meta-analysis. JAMA Netw Open. 2022;5(12):e2248593. doi:10.1001/jamanetworkopen.2022.48593