Neurofilament light chain in the vitreous humor of the eye

Abstract

Background

Neurofilament light chain (NfL) is a promising biomarker of neurodegeneration in the cerebrospinal fluid and blood. This study investigated the presence of NfL in the vitreous humor and its associations with amyloid beta, tau, inflammatory cytokines and vascular proteins, apolipoprotein E ( APOE) genotypes, Mini-Mental State Examination (MMSE) scores, systemic disease, and ophthalmic diseases.

Methods

This is a single-site, prospective, cross-sectional cohort study. Undiluted vitreous fluid (0.5–1.0 mL) was aspirated during vitrectomy, and whole blood was drawn for APOE genotyping. NfL, amyloid beta (Aβ), total Tau (t-Tau), phosphorylated Tau (p-Tau181), inflammatory cytokines, chemokines, and vascular proteins in the vitreous were quantitatively measured by immunoassay. The main outcome measures were the detection of NfL levels in the vitreous humor and its associations with the aforementioned proteins. Linear regression was used to test the associations of NfL with other proteins, APOE genotypes, MMSE scores, and ophthalmic and systemic diseases after adjustment for age, sex, education level, and other eye diseases.

Results

NfL was detected in all 77 vitreous samples. NfL was not found to be associated with ophthalmic conditions, APOE genotypes, MMSE scores, or systemic disease ( p > 0.05). NfL levels were positively associated with increased vitreous levels of Aβ ₄₀ ( p = 7.7 × 10 ⁻⁵), Aβ ₄₂ ( p = 2.8 × 10 ⁻⁴), and t-tau ( p = 5.5 × 10 ⁻⁷), but not with p-tau181 ( p = 0.53). NfL also had significant associations with inflammatory cytokines such as interleukin-15 (IL-15, p = 5.3 × 10 ⁻⁴), IL-16 ( p = 2.2 × 10 ⁻⁴), monocyte chemoattractant protein-1 (MCP1, p = 4.1 × 10 ⁻⁴), and vascular proteins such as vascular endothelial growth factor receptor-1 (VEGFR1, p = 2.9 × 10 ⁻⁶), Vegf-C ( p = 8.6 × 10 ⁻⁶), vascular cell adhesion molecule-1 (VCAM-1, p = 5.0 × 10 ⁻⁴), Tie-2 ( p = 6.3 × 10 ⁻⁴), and intracellular adhesion molecular-1 (ICAM-1, p = 1.6 × 10 ⁻⁴).

Conclusion

NfL is detectable in the vitreous humor of the eye and significantly associated with amyloid beta, t-tau, and select inflammatory and vascular proteins in the vitreous. Additionally, NfL was not associated with patients’ clinical eye condition. Our results serve as a foundation for further investigation of NfL in the ocular fluids to inform us about the potential utility of its presence in the eye.