DIAGNOSTIC TEST PANEL 549
Neuromyelitis Optica Spectrum Disorder – Tissue Damage Biomarkers
Diagnostic test panel for NfL, and GFAp. For suspicion of multiple sclerosis (MS), Neuromyelitis optica spectrum disorder (NMOSD) or MOG-associated disease (MOGAD).
Indication
Suspicion of Multiple Sclerosis (MS), Neuromyelitis Optica Spectrum Disorder (NMOSD) or MOG-associated disease (MOGAD) supplementary testing of biomarkers
Sample material
Serum
- Minim. volume: 1,0 mL (0,5 mL x 2 tubes)
CSF
- Minim. volume: 1,0 mL (0,5 mL x 2 tubes)
Transport
Within Sweden
- frozen
International
- frozen
Clinical background
Glial Fibrillary Acidic Protein (GFAP) is a protein primarily found in astrocytes in the central nervous system (CNS) and is crucial for cellular stability and function. The expression of GFAP increases during astrocyte activation and is released into cerebrospinal fluid (CSF) following tissue damage. GFAP can cross the blood-brain barrier (BBB) into the bloodstream, and its blood levels can be used to monitor CNS injury.
GFAP in blood serves as a nonspecific marker reflecting the extent and severity of CNS damage. Serum GFAP levels have been shown to be valuable in cases of traumatic brain injury (TBI), stroke, and certain neurodegenerative and neuroinflammatory conditions. In the diagnosis of neuroinflammatory disorders, CSF GFAP levels can help differentiate between multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD), which may initially be challenging to distinguish clinically.
Neurofilament light protein (NfL) is a subunit of neurofilaments, which form part of the neuronal cytoskeleton in both the central and peripheral nervous systems (CNS and PNS). In cases of axonal damage within the CNS, NfL leaks into the CSF, and elevated levels can be detected in serum/plasma. In CNS injuries, blood NfL levels are significantly lower than in CSF, but there is a strong correlation between them.
Serum/plasma NfL levels can indicate the degree of neuronal degradation in both CNS and PNS injuries. However, elevated NfL levels are a nonspecific marker of neuronal damage and do not provide information on the underlying cause. Since NfL levels in serum/plasma vary significantly among individuals in the general population, reference ranges are broad. Therefore, it is advisable to monitor patients individually, with an initial sample taken during a period of no active inflammation for at least three months. This value can then serve as the patient’s personal reference, and a difference of more than 20% between two samples is considered significant.
When the cause of CNS damage is unclear, NfL should ideally be analyzed alongside other brain injury markers in CSF, including GFAP (astrocyte injury marker), Tau (cortical injury marker), Beta-amyloid (dementia marker), and S-100 (acute brain injury marker).
Tests included in panel
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How to order
This test panel is available worldwide for hospitals, clinics, and physicians.
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Print and complete the request form
Download the request form. Clearly state the name and phone number of the referring hospital, clinic, or physician. -
Prepare your samples
Serum: At least At least 2 tubes. 0.5 mL serum (plain serum tubes without additives).
CSF: At least 2 tubes x 0.5 mL CSF (polypropylene tubes).
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Send samples and request form
Within Sweden
Send samples frozen to:
Envelopes and smaller boxes:
Wieslab AB, Box 50117, 20211 Malmö, Sweden
Larger boxes and frozen samples:
Wieslab AB, Lundavägen 151, 21224 Malmö, Sweden
International
Send samples frozen to:
Wieslab AB, Lundavägen 151, 21224 Malmö, Sweden
Last updated: 2025-08-18
