Nusinersen treatment and cerebrospinal fluid neurofilaments: An explorative study on Spinal Muscular Atrophy type 3 patients

Irene Faravelli, Megi Meneri, Domenica Saccomanno, Daniele Velardo, Elena Abati, Delia Gagliardi, Valeria Parente, Lucia Petrozzi, Dario Ronchi, Nino Stocchetti, Edoardo Calderini, Grazia D’Angelo, Giovanna Chidini, Edi Prandi, Giulia Ricci, Gabriele Siciliano, Nereo Bresolin, Giacomo Pietro Comi, Stefania Corti, Francesca MagriAlessandra Govoni

Research output: Contribution to journalArticle

Abstract

The antisense oligonucleotide Nusinersen has been recently licensed to treat spinal muscular atrophy (SMA). Since SMA type 3 is characterized by variable phenotype and milder progression, biomarkers of early treatment response are urgently needed. We investigated the cerebrospinal fluid (CSF) concentration of neurofilaments in SMA type 3 patients treated with Nusinersen as a potential biomarker of treatment efficacy. The concentration of phosphorylated neurofilaments heavy chain (pNfH) and light chain (NfL) in the CSF of SMA type 3 patients was evaluated before and after six months since the first Nusinersen administration, performed with commercially available enzyme-linked immunosorbent assay (ELISA) kits. Clinical evaluation of SMA patients was performed with standardized motor function scales. Baseline neurofilament levels in patients were comparable to controls, but significantly decreased after six months of treatment, while motor functions were only marginally ameliorated. No significant correlation was observed between the change in motor functions and that of neurofilaments over time. The reduction of neurofilament levels suggests a possible early biochemical effect of treatment on axonal degeneration, which may precede changes in motor performance. Our study mandates further investigations to assess neurofilaments as a marker of treatment response.

Original languageEnglish
JournalJournal of Cellular and Molecular Medicine
DOIs
Publication statusAccepted/In press - Jan 1 2020

Keywords

  • neurofilaments
  • Nusinersen
  • pharmacodynamics biomarker
  • spinal muscular atrophy

ASJC Scopus subject areas

  • Molecular Medicine
  • Cell Biology

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