Soluble biomarkers for Neuromyelitis Optica Spectrum Disorders: a mini review

Abstract

The Neuromyelitis Optica Spectrum Disorders (NMOSD) constitute a spectrum of rare autoimmune diseases of the central nervous system characterized by episodes of transverse myelitis, optic neuritis, and other demyelinating attacks. Previously thought to be a subtype of multiple sclerosis, NMOSD is now known to be a distinct disease with unique pathophysiology, clinical course, and treatment options. Although there have been significant recent advances in the diagnosis and treatment of NMOSD, the field still lacks clinically validated biomarkers that can be used to stratify disease severity, monitor disease activity, and inform treatment decisions. Here we review many emerging NMOSD biomarkers including markers of cellular damage, neutrophil-to-lymphocyte ratio, complement, and cytokines, with a focus on how each biomarker can potentially be used for initial diagnosis, relapse surveillance, disability prediction, and treatment monitoring.

Keywords: NMO; glial fibrillary acidic protein; lymphocyte; neurofilament; neutrophil.

Figure 1

Summary of key NMOSD biomarkers and their clinical utility during various stages of disease. Except where indicated, all referenced biomarkers are from serum. *Relapse prediction for serum GFAP has only been shown within <1 week preceding relapse.