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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

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Volume 53, Issue 10


Neurofilament medium polypeptide (NFM) protein concentration is increased in CSF and serum samples from patients with brain injury

Eduardo Martínez-Morillo
  • Lunenfeld-Tanenbaum Research Institute, Joseph and Wolf Lebovic Health Complex, Mount Sinai Hospital, Toronto, ON, Canada
  • Department of Clinical Biochemistry, Laboratory of Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
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/ Charmaine Childs
  • Centre for Health and Social Care Research, Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
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/ Belén Prieto García
  • Department of Clinical Biochemistry, Laboratory of Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
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/ Francisco V. Álvarez Menéndez
  • Department of Clinical Biochemistry, Laboratory of Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain
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/ Alexander D. Romaschin
  • Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
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/ Gianfranco Cervellin / Giuseppe LippiORCID iD: http://orcid.org/0000-0001-9523-9054 / Eleftherios P. Diamandis
  • Corresponding author
  • Pathology and Laboratory Medicine Department, Mount Sinai Hospital, Suite 6-201, Box 32, 60 Murray Street, Toronto, ON M5T 3L9, Canada
  • Department of Clinical Biochemistry, University Health Network, Toronto, ON, Canada
  • Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2015-02-07 | DOI: https://doi.org/10.1515/cclm-2014-0908


Background: Brain injury is a medical emergency that needs to be diagnosed and treated promptly. Several proteins have been studied as biomarkers of this medical condition. The aims of this study were to: 1) evaluate the selectivity and precision of a commercial ELISA kit for neurofilament medium polypeptide (NFM) protein; and 2) evaluate the concentration in cerebrospinal fluid (CSF) and serum of healthy individuals and patients with brain damage.

Methods: An ELISA from Elabscience was used. The selectivity was evaluated using size-exclusion chromatography and mass spectrometry. Intra- and inter-batch coefficients of variation (CV) were also studied. Fifty-one CSF samples from 36 age-matched patients with hemorrhagic stroke (HS) (n=30), ischemic stroke (IS) (n=11) and healthy individuals (n=10) were assayed. In addition, serum samples from healthy volunteers (n=47), 68 serum samples from seven patients with HS, 106 serum samples from 12 patients with traumatic brain injury (TBI) and 68 serum samples from 68 patients with mild traumatic brain injury (mTBI) were also analyzed.

Results: NFM was identified in the chromatographic fraction with highest immunoreactivity. The intra- and inter-batch CVs were ≤10% and ≤13%, respectively. The CSF-NFM concentration in HS was significantly higher (p<0.0001) than in IS and controls. Serum NFM concentration ranged from 0.26 to 8.57 ng/mL in healthy individuals (median=2.29), from 0.97 to 42.4 ng/mL in HS (median=10.8) and from 3.48 to 45.4 ng/mL in TBI (median=14.7). Finally, 44% of patients with mTBI had increased NFM concentration, with significantly higher levels (p=0.01) in patients with polytrauma.

Conclusions: To our knowledge this is the first study describing increased NFM levels in CSF and serum from patients with brain damage.

This article offers supplementary material which is provided at the end of the article.

Keywords: biomarker; brain injury; cerebrospinal fluid; neurofilament; serum; stroke


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About the article

Corresponding author: Eleftherios P. Diamandis, MD, PhD, FRCPC, FRSC, Pathology and Laboratory Medicine Department, Mount Sinai Hospital, Suite 6-201, Box 32, 60 Murray Street, Toronto, ON M5T 3L9, Canada, Phone: +1 416 586 8443, Fax: +1 416 619 5521, E-mail: ; Department of Clinical Biochemistry, University Health Network, Toronto, ON, Canada; and Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada

Received: 2014-09-14

Accepted: 2015-01-06

Published Online: 2015-02-07

Published in Print: 2015-09-01

Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 53, Issue 10, Pages 1575–1584, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2014-0908.

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