The good thing about sNfL: With the help of a simple blood test compared to CSF sampling, it is possible to determine in patient cohorts, i.e. larger groups, but also in individual patients whether certain nerve breakdown products occur within normal limits or are elevated. Something that has so far taken place under the radar of doctors and patients.
More precise treatment for MS, thanks to NfL
If the sNfL is increased, then there is a high probability that another attack will occur in the next one to two years. It’s important to know because this means you can increase your therapy in good time and possibly avert the attack and the resulting disabilities. In the opposite case, if the NFL values decrease, you also have an objective value for a possible de-escalation or the discontinuation of MS therapy. However, multiple sclerosis remains unpredictable for the individual: even an NfL test cannot predict which functions may be lost during an attack; even less how much a possible restriction will burden the individual.
Although an sNfL test is comparatively easy to obtain (taking blood instead of taking liquor), the values are by no means easy to assess. This is due to the fact that the NFL level in our blood increases over the course of our lives and is therefore age-dependent. In addition, people with a higher body mass index also have a higher NFL value. And: Other illnesses can also cause an increase in neurofilament light chains, for example diabetes or high blood pressure.
Less than a cube of sugar in an Olympic swimming pool
So you have to look at the value in the context of the individual patient. And work very precisely: While NFL are more present in the cerebrospinal fluid, they only occur in trace amounts in the blood. For comparison: a few percent of a sugar cube in an Olympic swimming pool. In order to be able to measure such small amounts – NfL occurs in pictograms per milliliter of blood, i.e. only trillionths of a gram – special measuring methods (immunoassays) are required.
