Serum levels of neurofilament light chain and glial fibrillary acidic protein correlate with disease severity in patients with West Nile virus infection

West Nile virus (WNV) is a neurotropic mosquito-borne orthoflavivirus, representing a relevant public health threat. Identification of biomarkers that would predict the course of WNV infection is of interest for the early identification of patients at risk and for supporting decisions on therapeutic...

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Main Authors: Alessandro Dinoto, Monia Pacenti, Sara Mariotto, Davide Abate, Vittoria Lisi, Sorsha Satto, Stefania Vogiatzis, Vanessa Chiodega, Sara Carta, Sergio Ferrari, Luisa Barzon
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Emerging Microbes and Infections
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Online Access:https://www.tandfonline.com/doi/10.1080/22221751.2024.2447606
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author Alessandro Dinoto
Monia Pacenti
Sara Mariotto
Davide Abate
Vittoria Lisi
Sorsha Satto
Stefania Vogiatzis
Vanessa Chiodega
Sara Carta
Sergio Ferrari
Luisa Barzon
author_facet Alessandro Dinoto
Monia Pacenti
Sara Mariotto
Davide Abate
Vittoria Lisi
Sorsha Satto
Stefania Vogiatzis
Vanessa Chiodega
Sara Carta
Sergio Ferrari
Luisa Barzon
author_sort Alessandro Dinoto
collection DOAJ
description West Nile virus (WNV) is a neurotropic mosquito-borne orthoflavivirus, representing a relevant public health threat. Identification of biomarkers that would predict the course of WNV infection is of interest for the early identification of patients at risk and for supporting decisions on therapeutic interventions. In this study, serum levels of glial fibrillary acidic protein (sGFAP) and neurofilament light chain (sNfL), which are markers of brain tissue damage and inflammation, were analysed in 103 subjects with laboratory-confirmed WNV infection, comprising 13 asymptomatic blood donors, 23 with WN fever (WNF), 50 with encephalitis/meningoencephalitis (E/ME) and 17 with acute flaccid paralysis (AFP). In addition, 55 WNV-negative subjects with fever, encephalitis or healthy asymptomatic were included as controls. Age-adjusted levels of both sNfL and sGFAP were significantly higher in patients with neuroinvasive disease than in those with fever or asymptomatic (both WNV-positive and WNV-negative), suggesting a broad association of these biomarkers with systemic inflammation and brain injury resulting from infection. In WNV patients, the combined analysis of sNfL and sGFAP early after symptom onset allowed discrimination between neuroinvasive disease and fever with 67.2% sensitivity and 91.3% specificity, but not between E/ME and AFP. Furthermore, high levels of sNfL and sGFAP were significantly associated with prolonged hospital stay, intensive care unit admission and the occurrence of death or severe sequelae. Detection of WNV RNA in CSF was associated with increased sGFAP. In conclusion, our study indicates the potential utility of sNfL and sGFAP as biomarkers of WNV disease severity and adverse outcome.
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spelling doaj-art-a6b50c42002a4537abe514a2fb1a0d7a2025-08-20T01:56:41ZengTaylor & Francis GroupEmerging Microbes and Infections2222-17512025-12-0114110.1080/22221751.2024.2447606Serum levels of neurofilament light chain and glial fibrillary acidic protein correlate with disease severity in patients with West Nile virus infectionAlessandro Dinoto0Monia Pacenti1Sara Mariotto2Davide Abate3Vittoria Lisi4Sorsha Satto5Stefania Vogiatzis6Vanessa Chiodega7Sara Carta8Sergio Ferrari9Luisa Barzon10Section of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, ItalyMicrobiology and Virology Unit, Padova University Hospital, Padova, ItalySection of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, ItalyMicrobiology and Virology Unit, Padova University Hospital, Padova, ItalyMicrobiology and Virology Unit, Padova University Hospital, Padova, ItalyMicrobiology and Virology Unit, Padova University Hospital, Padova, ItalyDepartment of Molecular Medicine, University of Padova, Padova, ItalySection of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, ItalySection of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, ItalySection of Neurology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, ItalyMicrobiology and Virology Unit, Padova University Hospital, Padova, ItalyWest Nile virus (WNV) is a neurotropic mosquito-borne orthoflavivirus, representing a relevant public health threat. Identification of biomarkers that would predict the course of WNV infection is of interest for the early identification of patients at risk and for supporting decisions on therapeutic interventions. In this study, serum levels of glial fibrillary acidic protein (sGFAP) and neurofilament light chain (sNfL), which are markers of brain tissue damage and inflammation, were analysed in 103 subjects with laboratory-confirmed WNV infection, comprising 13 asymptomatic blood donors, 23 with WN fever (WNF), 50 with encephalitis/meningoencephalitis (E/ME) and 17 with acute flaccid paralysis (AFP). In addition, 55 WNV-negative subjects with fever, encephalitis or healthy asymptomatic were included as controls. Age-adjusted levels of both sNfL and sGFAP were significantly higher in patients with neuroinvasive disease than in those with fever or asymptomatic (both WNV-positive and WNV-negative), suggesting a broad association of these biomarkers with systemic inflammation and brain injury resulting from infection. In WNV patients, the combined analysis of sNfL and sGFAP early after symptom onset allowed discrimination between neuroinvasive disease and fever with 67.2% sensitivity and 91.3% specificity, but not between E/ME and AFP. Furthermore, high levels of sNfL and sGFAP were significantly associated with prolonged hospital stay, intensive care unit admission and the occurrence of death or severe sequelae. Detection of WNV RNA in CSF was associated with increased sGFAP. In conclusion, our study indicates the potential utility of sNfL and sGFAP as biomarkers of WNV disease severity and adverse outcome.https://www.tandfonline.com/doi/10.1080/22221751.2024.2447606West Nile virusneurofilament light chainglial fibrillary acidic proteinencephalitisacute flaccid paralysis
spellingShingle Alessandro Dinoto
Monia Pacenti
Sara Mariotto
Davide Abate
Vittoria Lisi
Sorsha Satto
Stefania Vogiatzis
Vanessa Chiodega
Sara Carta
Sergio Ferrari
Luisa Barzon
Serum levels of neurofilament light chain and glial fibrillary acidic protein correlate with disease severity in patients with West Nile virus infection
Emerging Microbes and Infections
West Nile virus
neurofilament light chain
glial fibrillary acidic protein
encephalitis
acute flaccid paralysis
title Serum levels of neurofilament light chain and glial fibrillary acidic protein correlate with disease severity in patients with West Nile virus infection
title_full Serum levels of neurofilament light chain and glial fibrillary acidic protein correlate with disease severity in patients with West Nile virus infection
title_fullStr Serum levels of neurofilament light chain and glial fibrillary acidic protein correlate with disease severity in patients with West Nile virus infection
title_full_unstemmed Serum levels of neurofilament light chain and glial fibrillary acidic protein correlate with disease severity in patients with West Nile virus infection
title_short Serum levels of neurofilament light chain and glial fibrillary acidic protein correlate with disease severity in patients with West Nile virus infection
title_sort serum levels of neurofilament light chain and glial fibrillary acidic protein correlate with disease severity in patients with west nile virus infection
topic West Nile virus
neurofilament light chain
glial fibrillary acidic protein
encephalitis
acute flaccid paralysis
url https://www.tandfonline.com/doi/10.1080/22221751.2024.2447606
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