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Axonal degeneration and inflammation in acute optic neuritis
  1. A Petzold1,
  2. K Rejdak3,
  3. G T Plant2
  1. 1Department of Neuroinflammation, Institute of Neurology, University College London, Queen Square, London WCIN 3BG, UK
  2. 2Moorfields Eye Hospital, Department of Neuro-ophthalmology, City Road, London ECJ 2PD, UK
  3. 3Department of Neurology, Medical University of Lublin, Poland
  1. Correspondence to:
 Dr A Petzold
 Department of Neuroinflammation, Institute of Neurology, Queen Square, London WC1N 3BG, UK;


Aims: To investigate whether plasma biomarkers for axonal injury and inflammation are related to loss and recovery of visual function in acute optic neuritis (ON).

Methods: Eighteen patients with ON and 14 controls were investigated in a longitudinal, prospective study. Plasma phosphorylated neurofilament heavy chain (NfHSMI35; a surrogate marker of axonal injury), nitric oxide metabolites (NOx), and citrulline (surrogate markers of inflammation) were measured.

Results: Patients with ON had higher median plasma NfHSMI35 values than controls (0.17 versus 0.005 ng/ml; p < 0.05) and higher NOx values (49 versus 35.5μM; p < 0.001). Plasma NfHSMI35 values correlated inversely with visual acuity at presentation (R  =  −0.67; p  =  0.01). NfHSMI35 was higher in patients with poor recovery of visual acuity than in those with good recovery (0.25 ng/ml versus 0.09 ng/ml; p < 0.05). Three of four patients with high NfHSMI35 and high NOx values experienced a poor recovery as opposed to only one of five with high NOx but normal NfHSMI35 values.

Conclusions: NfHSMI35, a surrogate marker for axonal damage, is a prognostic indicator and should be considered in the design of neuroprotective treatment strategies.

  • MRI, magnetic resonance imaging
  • MS, multiple sclerosis
  • NfHSM135, phosphorylated neurofilament heavy chain
  • NOx, nitric oxide metabolites
  • ON, optic neuritis
  • VA, visual acuity
  • surrogate marker
  • NfHSM135
  • nitric oxide metabolites
  • citrulline
  • optic neuritis
  • axonal loss
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  • Competing interests: none declared

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