Browsing by Author "Munube, Deogratias"

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    Neurofilament Light Chain: A potential biomarker for cerebrovascular disease in children with sickle cell anemia
    (Wiley, 2023) Green, Nancy S.; Rosano, Caterina; Bangirana, Paul; Opoka, Robert; Munube, Deogratias; Kasirye, Philip; Kawooya, Michael; Lubowa, Samson K.; Mupere, Ezekiel; Conroy, Andrea; Minja, Frank J.; Boehme, Amelia K.; Kang, Min Suk; Honig, Lawrence S.; Idro, Richard; Pediatrics, School of Medicine
    Cerebrovascular 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.