Neuronal inflammation-associated biomarkers in cerebrospinal fluid of patients with acute and chronic inflammatory demyelinating polyneuropathies.

BACKGROUND

Immune-mediated polyneuropathies such as acute and chronic inflammatory demyelinating polyneuropathy are challenging to diagnose and treat effectively.

OBJECTIVE

To investigate the diagnostic value of certain biomarkers associated with neuronal inflammation in patients with inflammatory demyelinating polyneuropathy.

METHODS

Medical records of patients who presented to the Neurology Clinic of BAİBÜ Education and Research Hospital between December 2023 and October 2024 and underwent lumbar puncture (LP) for diagnostic purposes were retrospectively reviewed. CSF samples and clinical data of 20 AIDP patients, 18 CIDP patients, and 15 patients with pseudotumor cerebri (PTC), included as the unhealthy control group, were analyzed.

RESULTS

The CSF levels of NfL, NfH, GFAP, SM, and BDNF in the AIDP group were significantly higher than those in the PTC group (p < 0.05). In the CIDP group, CSF NfL, GFAP, and SM levels were significantly elevated compared to the PTC group (p < 0.05), while no significant difference was observed in CSF NfH and BDNF levels between the CIDP and PTC groups. Furthermore, the AIDP group had significantly higher levels of NfH and BDNF in CSF compared to the CIDP group (p < 0.05).

CONCLUSIONS

These findings suggest that in AIDP and CIDP patients, the elevation of CSF NfL, NfH, and GFAP levels may be associated with secondary proximal axonal damage. Additionally, SM could serve as an indicator of myelin breakdown and remodeling, while the compensatory effect of BDNF may support remyelination. In conclusion, these five biomarkers may represent promising targets for the early diagnosis and differential diagnosis of AIDP and CIDP.