Neurol. praxi. 2026;27(3):218-221 | DOI: 10.36290/neu.2026.033

Neurofilament light chain (NfL) and glial fibrillary acid protein (GFAP) as biomarkers disease activity and therapeutic response in multiple sclerosis treated with ocrelizumab

prof. MUDr. Pavel Štourač, Ph.D.
Neurologická klinika Fakultní nemocnice Brno, Masarykova univerzita Brno

Multiple sclerosis is chronic autoimmune disease with very variable interindividual clinical course and response to the treatment. There is an effort to find biomarkers which reflect two basic aspects of immunopathogenesis of multiple sclerosis, i.e. inflammatory activity and neurodegeneration. We have two biomarkers, neurofilament light chains and glial fibrillary acidic protein measured in serum which mirror both processes, i.e. neuroinflammation and neurodegeneration. We will be able to evaluate the drug efficacy, as shown in this report specifically of ocrelizumab in multiple sclerosis and to modify the treatment according to the principles of personalized medicine.

Keywords: biomarkers, neurofilament light chains, glial fibrillary acidic protein, multiple sclerosis, ocrelizumab.

Received: April 14, 2026; Revised: June 8, 2026; Accepted: June 25, 2026; Prepublished online: June 25, 2026; Published: July 20, 2026  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Štourač P. Neurofilament light chain (NfL) and glial fibrillary acid protein (GFAP) as biomarkers disease activity and therapeutic response in multiple sclerosis treated with ocrelizumab. Neurol. praxi. 2026;27(3):218-221. doi: 10.36290/neu.2026.033.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Purchase PDF - 60 CZK (2.5 EUR)
    will be unlocked 20.7.2027

    References

    1. Abdelhak A, Benkert P, Schaedelin S, et al. Neurofilament light chain elevation and disability progression in multiple sclerosis. JAMA Neurol. 2023;80:1317-25. Go to original source...
    2. Abdelhak A, Petermeier F, Benkert P, et al. Serum neurofilament light chain reference database for individual application in paediatric care: a retrospective modelling and validation study. Lancet Neurol. 2023;22:826-33. Go to original source...
    3. Absinta M, Sati P, Masozzo F, et al. Association of chronic active multiple sclerosis lesions with disability in vivo. JAMA Neurol. 2019;76(12):1474-1483. doi: 10.1001/jamaneurol.2019.2019.2399. Go to original source...
    4. Akgűn K, Kretschmann N, Haase R, et al. Profiling individual clinical responses by high- frequency serum neurofilament assesment in MS. Neurol Neuroimmunol Neuroinflamm. 2019;6:e555. Go to original source...
    5. Antel J, Antel S, Caramanos Z, et al. Primary progressive multiple sclerosis:part of MS disease spectrum or separate disease entity? Acta Neuropathol. 2012;123(5):627-638. doi:10.1007/s00401-012-0953-0. Go to original source...
    6. Axelsson M, Malmoström C, Gunarsson M, et al. Immunosupresive therapy reduces axonal damage in progressive multiple sclerosis. Mult Scler. 2014;20:43-50. Go to original source...
    7. Bar-Or A, Li R. Cellular imunology of relapsing multiple sclerosis: interactions, checks and balances. Lancet Neurol. 2021;20(6):470-483. doi:10.1016/S1474-4422(21)00063-6. Go to original source... Go to PubMed...
    8. Bar-Or A, Thanei G, Harp C, et al. Actrims/Ectrims Meeting 2020, poster presentation. number P0125p.
    9. Bar-Or A, Thanei GA, Harp C, et al. Blood neurofilament light levels predict non-relapsing progression following anti -CD20 therapy in relapsing and primary progressive multiple sclerosis:findings from ocrelizumab randomised,double -blind phase 3 clinical trials. EBio Medicine. 2023;93:104662. Go to original source...
    10. Barro C, Healy BC, Liu Y, et al. Serum GFAP and NfL levels differentiate subsequent progression and disease activity in patients with progressive multiple sclerosis. Neurol Neuroimmunol Neuroinflamm. 2022;10:e200052. Go to original source...
    11. Barro Ch, Healy CB, Liu Y, et al. Serum GFAP and NfL levels differentiate subsequent progression and disease activity in patients with progressive multiple sclerosis. Neurol Neuroimmunol Neuroinflamm. 2023;10:e200052. doi: 10.1212/NXI.0000000000200052. Go to original source... Go to PubMed...
    12. Cross AH,Gelfand JM, Thebault S, et al. Emerging cerebrospinal fluid biomarkers of disease activity and progression in multiple sclerosis. JAMA Neurol. 2024;81:373-83. Go to original source...
    13. Elliot C,Wollinsky JS, Hauser LS, et al. Slowly expanding /evolving lesions as a magnetic resonance imaging marker of chronic active multiple sclerosis lesions. Mult Scler. 2019;25(14):1915-1925. doi:10.1177/1352458518814117. Go to original source... Go to PubMed...
    14. Freedman MS, Gnanapavan S, Booth AR, et al. Guidance for use of neurofilament light chain as a cerebrospinal fluid and blood biomarker in multiple sclerosis management. EBio Medicine. 2024;101:104970. doi: 10.1016/j.ebiom2024.104970. Go to original source...
    15. Gil-Perotin S, Castillo-Villalba J, Cubas-Nuňez L, et al. Combined cerebrospinal fluid neurofilament light chain protein and chitinase 3 like-1 levels in defining disease course and prognosis in multiple sclerosis. Front Neurol. 2019;10:1008. Go to original source...
    16. Gunnarson M, Malmeström C, Axelsson M, et al. Axonal damage in relapsing multiple sclerosis is markedly reduced by natalizumab. Ann Neurol. 201;69:83-89.
    17. Huss A, Otto M, Senel M, et al. A score based on NfL and glial markers may differentiate between relapsing-remitting and progressive diisease course. Front Neurol. 2020;11:608. Go to original source...
    18. Jorge FR,Velasco JI,Villarubia N, et al. Biomarkers of response to ocrelizumab in relapsing - remitting multiple sclerosis. Front Immunol. 2024;15:1480676. Go to original source...
    19. Lassmann H. Pathogenic mechanism associated with different clinical courses of multiple sclerosis. Front Immunol. 2019;9:3116-3116. doi :10.3389/fimmu.2018.03116. Go to original source... Go to PubMed...
    20. Lublin FD, CoetzeeT, Cohen JA, et al. The 2013 clinical course descriptors for multiple sclerosis: a clarification. Neurology. 2020;94:1088-92. Go to original source...
    21. Madill E, Fereirra MV, Healy B, et al. Change in serum neurofilament light chain and glial fibrillary acidic protein level with high-efficacy and low-efficacy early therapy in multiple sclerosis. Mult Scler J. 2025;vol.31(8):944-954. doi: 10.1177/13524585251335521. Go to original source... Go to PubMed...
    22. Madill E, Healy BC, Molazadeh N, et al. Serum glial fibrillary acidic protein predicts disease progression in multiple sclerosis. Ann Clin Transl Neurol. 2024;11:2719-30. Go to original source...
    23. Meier S, Willemse EAJ, Schaedelin S, et al. Serum glial fibrillary acidic protein compared with neurofilament light chain as a biomarker for disease progression in multiple sclerosis. JAMA Neurol. 2023;80:287-97. Go to original source...
    24. Roso M, Gonzalez CT, Healy BC, et al. Temporal association of sNfL and Gad - enhancing lesions in multiple sclerosis. Ann Clin Transl Neurol. 2020;7:945-55. Go to original source...
    25. Rosso M, Healy BC, Saxena S, et al. MRI lesion state modulates the relationship between serum neurofilament light and age in multiple sclerosis. J Neuroimaging. 2021;31:399-93. Go to original source...
    26. Schaefer JH, Schaller-Paule MA, Wenger K, et al. Relevance of dedicated multiple sclerosis serum biomarkers in predicting contract enhancement with gadolinium: results from the REDUCE - GAD trial. Eur J Neurol. 2023;30:2393-400. Go to original source...

    Return to the content


    Neurology for Practice

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.