Neuroinflammation Is Associated with GFAP and sTREM2 Levels in Multiple Sclerosis

Biomolecules. 2022 Jan 27;12(2):222. doi: 10.3390/biom12020222.


Background: Astrocytes and microglia play an important role in the inflammatory process of multiple sclerosis (MS). We investigated the associations between the cerebrospinal fluid (CSF) levels of glial fibrillary acid protein (GFAP) and soluble triggering receptors expressed on myeloid cells-2 (sTREM-2), inflammatory molecules, and clinical characteristics in a group of patients with relapsing-remitting MS (RRMS). Methods: Fifty-one RRMS patients participated in the study. Clinical evaluation and CSF collection were performed at the time of diagnosis. The CSF levels of GFAP, sTREM-2, and of a large set of inflammatory and anti-inflammatory molecules were determined. MRI structural measures (cortical thickness, T2 lesion load, cerebellar volume) were examined. Results: The CSF levels of GFAP and sTREM-2 showed significant correlations with inflammatory cytokines IL-8, G-CSF, and IL-5. Both GFAP and sTREM-2 CSF levels positively correlated with age at diagnosis. GFAP was also higher in male MS patients, and was associated with an increased risk of MS progression, as evidenced by higher BREMS at the onset. Finally, a negative association was found between GFAP CSF levels and cerebellar volume in RRMS at diagnosis. Conclusions: GFAP and sTREM-2 represent suitable biomarkers of central inflammation in MS. Our results suggest that enhanced CSF expression of GFAP may characterize patients with a higher risk of progression.

Keywords: astroglia; cerebrospinal fluid (CSF) biomarkers; cytokines; glial fibrillary acid protein (GFAP); microglia; multiple sclerosis (MS); neurodegeneration; neuroinflammation; soluble triggering receptor expressed on myeloid cells-2 (sTREM-2).

MeSH terms

  • Biomarkers / cerebrospinal fluid
  • Glial Fibrillary Acidic Protein* / cerebrospinal fluid
  • Humans
  • Male
  • Membrane Glycoproteins* / cerebrospinal fluid
  • Multiple Sclerosis* / cerebrospinal fluid
  • Multiple Sclerosis, Relapsing-Remitting* / cerebrospinal fluid
  • Neuroinflammatory Diseases / cerebrospinal fluid
  • Receptors, Immunologic*


  • Biomarkers
  • GFAP protein, human
  • Glial Fibrillary Acidic Protein
  • Membrane Glycoproteins
  • Receptors, Immunologic
  • TREM2 protein, human