Green, Nancy S.Rosano, CaterinaBangirana, PaulOpoka, RobertMunube, DeogratiasKasirye, PhilipKawooya, MichaelLubowa, Samson K.Mupere, EzekielConroy, AndreaMinja, Frank J.Boehme, Amelia K.Kang, Min SukHonig, Lawrence S.Idro, Richard2024-12-122024-12-122023Green NS, Rosano C, Bangirana P, et al. Neurofilament light chain: A potential biomarker for cerebrovascular disease in children with sickle cell anaemia. Br J Haematol. 2023;203(3):460-467. doi:10.1111/bjh.19036https://hdl.handle.net/1805/44964Cerebrovascular injury frequently occurs in children with sickle cell anaemia (SCA). Limited access to magnetic resonance imaging and angiography (MRI-MRA) in sub-Saharan Africa impedes detection of clinically unapparent cerebrovascular injury. Blood-based brain biomarkers of cerebral infarcts have been identified in non-SCA adults. Using plasma samples from a well-characterized cross-sectional sample of Ugandan children with SCA, we explored relationships between biomarker levels and MRI-detected cerebral infarcts and transcranial Doppler (TCD) arterial velocity. Testing was performed using a 4-plex panel of brain injury biomarkers, including neurofilament light chain (NfL), a central nervous system neuron-specific protein. Mean biomarker levels from the SCA group (n = 81) were similar to those from non-SCA sibling controls (n = 54). Within the SCA group, NfL levels were significantly higher in those with MRI-detected infarcts compared to no infarcts, and higher with elevated TCD velocity versus normal velocity. Elevated NfL remained strongly associated with MRI-detected infarcts after adjusting for sex and age. All non-SCA controls and SCA participants lacking MRI-detected infarcts had low NfL levels. These data suggest potential utility of plasma-based NfL levels to identify children with SCA cerebrovascular injury. Replication and prospective studies are needed to confirm these novel findings and the clinical utility of NfL versus MRI imaging.en-USPublisher PolicyUgandaBrain biomarkersCerebral infarctsMagnetic resonance imagingSickle cell anaemiaArticle