Researchers have identified a new prognostic biomarker for Guillain-Barré syndrome (GBS), a rare autoimmune disorder that attacks the nerves and can eventually paralyze the entire body. The biomarker, neurofilament light chain, or NfL, signals the presence of axonal damage. As published in the Journal of Neurology, Neurosurgery, and Psychiatry, high circulating levels of NfL in GBS patients were found to be associated with more severe disabilities.
These findings significantly impact the clinical strategies for managing GBS and increase neurologists' understanding of the physiological processes underlying this devastating disease.
"First, they confirm that residual long-term disability in GBS is clearly associated to the degree of axonal damage that happens at the onset of the disease," said Luis Querol, senior author of the study.
"They also suggest that serum NfL could be used to stratify patients at admission, and in the future, select patients who may be candidates for more aggressive therapies or those who may have good prognosis independently of the apparent severity they have at onset," said Querol.
The root causes of GBS continue to mystify scientists, although a large proportion of patients report having a severe respiratory or gastrointestinal infection in the leadup to the disease. Among the early signs of GBS are a prickling sensation in the fingers, limb weakness, and double vision.
Measuring the degeneration of axons, or nerve fibers, can determine a GBS patient’s outcomes and shape clinical interventions moving forward, said Bart Jacobs from the Erasmus Medical Center in Rotterdam.
In an editorial on the study, Jacobs writes: "Axonal injury may occur in AMAN as well as acute inflammatory demyelinating polyneuropathy and in severe cases may result in irreversible degeneration. Treatment with immunoglobulins or plasma-exchange aims to prevent further axonal injury, but clinicians currently have no methods to monitor the response directly."
Sources: MedPage Today, Journal of Neurology, Neurosurgery & Psychiatry.