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PERSPECTIVE article
Front. Neurol.
Sec. Multiple Sclerosis and Neuroimmunology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1571605
Steps toward the implementation of neurofilaments in multiple sclerosis: patient profiles to be prioritized in clinical practice
Provisionally accepted
Diego Centonze 1*
Alessia Di Sapio 2
Vincenzo Brescia Morra 3 Elena Colombo 4
Matilde Inglese 5
Damiano Paolicelli 6
Marco Salvetti 7
Roberto Furlan 8- 1 University of Rome Tor Vergata, Roma, Lazio, Italy
- 2 San Luigi Gonzaga University Hospital, Orbassano, Italy
- 3 University of Naples Federico II, Naples, Campania, Italy
- 4 Multiple Sclerosis Center, Neurological Institute Foundation Casimiro Mondino (IRCCS), Pavia, Lombardy, Italy
- 5 San Martino Hospital (IRCCS), Genova, Liguria, Italy
- 6 University of Bari Aldo Moro, Bari, Italy
- 7 Sapienza University of Rome, Rome, Lazio, Italy
- 8 Vita-Salute San Raffaele University, Milan, Lombardy, Italy
Multiple sclerosis (MS) is a chronic central nervous system disease characterized by neurodegeneration and inflammation. Neurofilament light chain (NfL), a protein released during axonal injury, has gained recognition as a potential biomarker for monitoring MS progression and treatment response. Evidence indicates that blood NfL (bNfL) offers a minimally invasive, costeffective tool for tracking neuroaxonal damage. Regular bNfL assessments can identify subclinical disease activity, guide treatment intensification, and support individualized care. However, bNfL level evaluation is currently not optimized in Italian clinical practice. This work examines the utility of bNfL monitoring in clinical practice, focusing on optimizing its use within specific patient profiles, especially in resource-limited settings. bNfL testing, particularly in targeted MS patient profiles, including stable patients exhibiting subclinical signs of disease activity, such as fatigue, and patients off-treatment, represents a promising adjunct for personalized disease management. Its integration into clinical practice, alongside MRI and clinical assessments, can enhance decision-making and improve care efficiency, especially in settings with limited MRI resources. Further research is needed to standardize testing protocols and establish disease-specific cutoffs.
Keywords: neurofilament light chain, blood NfL, Multiple Sclerosis, MS biomarker, clinical practice
Received: 05 Feb 2025; Accepted: 11 Mar 2025.
Copyright: © 2025 Centonze, Di Sapio, Brescia Morra, Colombo, Inglese, Paolicelli, Salvetti and Furlan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Diego Centonze, University of Rome Tor Vergata, Roma, 00173, Lazio, Italy
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