The biomarker neurofilament light (NfL) has taken on a central role in neurology drug development, with drugs being approved or dropped based on what they do to NfL. We, like everyone, long assumed increases in NfL always meant neuronal damage, and decreases in NfL meant amelioration thereof. Today we report some data that have made us think there may be exceptions. In human, mouse, and cell culture we see NfL rise after minocycline treatment. The increase is very specific to NfL, has rapid washout kinetics distinct from neuronal injury, and does not seem to be associated with any neurotoxic signature. Our hypothesis: minocycline, by inhibiting microglial activity, may block clearance of NfL. Pre-print: https://lnkd.in/eQs_dzHM Blog post: https://lnkd.in/eTeqQ6yK Open data & source code: https://lnkd.in/ejT5cMed
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With more and more endpoints of trials measuring nfl and go/no go decisions depending on its level, we must aware the likely drawbacks of such nfl subservience
The biomarker neurofilament light (NfL) has taken on a central role in neurology drug development, with drugs being approved or dropped based on what they do to NfL. We, like everyone, long assumed increases in NfL always meant neuronal damage, and decreases in NfL meant amelioration thereof. Today we report some data that have made us think there may be exceptions. In human, mouse, and cell culture we see NfL rise after minocycline treatment. The increase is very specific to NfL, has rapid washout kinetics distinct from neuronal injury, and does not seem to be associated with any neurotoxic signature. Our hypothesis: minocycline, by inhibiting microglial activity, may block clearance of NfL. Pre-print: https://lnkd.in/eQs_dzHM Blog post: https://lnkd.in/eTeqQ6yK Open data & source code: https://lnkd.in/ejT5cMed
Evidence that minocycline treatment confounds the interpretation of neurofilament as a biomarker
medrxiv.org
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Discover the latest research on how METTL1-driven tRNA m7G modification plays a crucial role in AML leukemogenesis through tRNA-modulated translational control. Read the insightful article published by Physicians Weekly in January 2024, summarizing the findings of Zhao et al.
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Professor of Neurology at University College London
3moOh this is YOU! This preprint has been making ripples in my tiny world but I scrolled right past the author list. It’s great and important work. The lesson for me is that an NFL increase on treatment may be tolerable if (1) you know why it’s happening and (2) you have reason to believe that it will be worth the wait, in the full context, for it to come down. I do worry that lots of people whose drugs have produced big NFL rises for the more prosaic reason will cite your work as a reason to press on regardless – investors are likely to be especially susceptible to this tactic - but that is not your problem!