Neurofilament Light Chains in Serum Predict Post—Transjugular Intrahepatic Portosystemic Shunt Hepatic Encephalopathy

Christian Labenz; Eva Maria Schleicher; Myriam Meineck; Martin A. Kabelitz; Alena F. Ehrenbauer; Anja Tiede; Jim B. Mauz; Sven Danneberg; Michael Bernhard Pitton; Falk Steffen; Julia Weinmann-Menke; Peter Robert Galle; Stefan Bittner; Felix Lüssi; Jens Uwe Marquardt; Benjamin Maasoumy; Simon Johannes Gairing

doi:10.1002/mco2.70475

Neurofilament Light Chains in Serum Predict Post—Transjugular Intrahepatic Portosystemic Shunt Hepatic Encephalopathy

Christian Labenz^*, Eva Maria Schleicher, Myriam Meineck, Martin A. Kabelitz, Alena F. Ehrenbauer, Anja Tiede, Jim B. Mauz, Sven Danneberg, Michael Bernhard Pitton, Falk Steffen, Julia Weinmann-Menke, Peter Robert Galle, Stefan Bittner, Felix Lüssi, Jens Uwe Marquardt, Benjamin Maasoumy, Simon Johannes Gairing

^*Korrespondierende/r Autor/-in für diese Arbeit

Medizinische Klinik I

Abstract

Hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) insertion constitutes a frequent and severe complication. However, there is a lack of robust predictive biomarkers for post-TIPS HE, so far. This study evaluated the usefulness of neurofilament light chains (NfL) and glial fibrillary acidic protein (GFAP) in serum for predicting post-TIPS HE. Around 144 patients with cirrhosis from three centers were prospectively included and monitored for the occurrence of post-TIPS overt HE, liver transplantation, and death. Serum NfL and GFAP were evaluated before TIPS insertion using the single molecule array technology. In a subgroup of patients sequential NfL and GFAP levels were assessed at 30- and 180-days post-TIPS. While higher NfL levels (sHR 1.01, p = 0.036) were independently associated with post-TIPS OHE after adjusting for other risk factors, GFAP levels had no predictive ability. Consistently, only elevated NfL levels were associated with a higher risk of death/liver transplantation in multivariable analyses. Sequential measurements of NfL at 30 and 180 days after TIPS revealed that NfL levels remain constant until Day 30 followed by a decrease at day 180. Notably, GFAP levels did not change over time. Thus, NfL could be a valuable biomarker for identifying high-risk patients for post-TIPS HE.

Originalsprache	Englisch
Aufsatznummer	e70475
Zeitschrift	MedComm
Jahrgang	6
Ausgabenummer	11
DOIs	https://doi.org/10.1002/mco2.70475
Publikationsstatus	Veröffentlicht - 11.2025

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JUM: Lecture and consultant fees: Merz Therapeutics, Falk Foundation e.V., ABBVIE, AstraZeneca, Gilead; Research grants: Merz Therapeutics SB: S.B. has received honoraria from Biogen, Bristol Myers Squibb, Hexal, Merck Healthcare, Novartis, Roche, Sanofi and Teva. S.B. is supported by the Deutsche Forschungsgemeinschaft (DFG, SFB CRC TRR 355 ‐ 480846870), Novartis and the Hermann‐ and Lilly‐Schilling Foundation. This work was partly supported by the German Center for Infectious Research (no approval number available) and by the Dr. Rolf M. Schwiete Stiftung (grant number: 2022–56). SJG: Travel expenses: Ipsen and Gilead. Research grant: Schwiete Foundation. This work was partly supported by the German Center for Infectious Research (no approval number available) and by the Dr. Rolf M. Schwiete Stiftung (grant number: 2022–56). This study was supported by the Schwiete Stiftung with a grant provided to Christian Labenz and Simon J. Gairing. Martin A. Kabelitz, Alena F. Ehrenbauer, Anja Tiede and Jim B. Mauz were supported by the KlinStrucMed-Program of Hannover Medical School. The authors thank Irina Wagner, Teresa Braun, Sina Liedke, Nathalie Eckel, Falko Zucker-Reimann, Dunja Amani, Laura Schmidtke and Julia Kowalczyk for excellent technical assistance. Open access funding enabled and organized by Projekt DEAL. EMS: received travel grants from Abbvie and Advitos.

Träger	Trägernummer
AstraZeneca
Novartis
Gilead
Leibniz Forschungszentrum Borstel
Ipsen and Gilead
Schwiete Foundation
Lilly‐Schilling Foundation
Dr. Rolf M. Schwiete Stiftung	2022–56
Medizinischen Hochschule Hannover
AbbVie
Merz Therapeutics
Deutsches Zentrum für Infektionsforschung
Falk Foundation
Deutsche Forschungsgemeinschaft	SFB CRC TRR 355 ‐ 480846870

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10.1002/mco2.70475

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Labenz, C., Schleicher, E. M., Meineck, M., Kabelitz, M. A., Ehrenbauer, A. F., Tiede, A., Mauz, J. B., Danneberg, S., Pitton, M. B., Steffen, F., Weinmann-Menke, J., Galle, P. R., Bittner, S., Lüssi, F., Marquardt, J. U., Maasoumy, B., & Gairing, S. J. (2025). Neurofilament Light Chains in Serum Predict Post—Transjugular Intrahepatic Portosystemic Shunt Hepatic Encephalopathy. MedComm, 6(11), Artikel e70475. https://doi.org/10.1002/mco2.70475

@article{d08f14d44886477f93737da832a368e7,

title = "Neurofilament Light Chains in Serum Predict Post—Transjugular Intrahepatic Portosystemic Shunt Hepatic Encephalopathy",

abstract = "Hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) insertion constitutes a frequent and severe complication. However, there is a lack of robust predictive biomarkers for post-TIPS HE, so far. This study evaluated the usefulness of neurofilament light chains (NfL) and glial fibrillary acidic protein (GFAP) in serum for predicting post-TIPS HE. Around 144 patients with cirrhosis from three centers were prospectively included and monitored for the occurrence of post-TIPS overt HE, liver transplantation, and death. Serum NfL and GFAP were evaluated before TIPS insertion using the single molecule array technology. In a subgroup of patients sequential NfL and GFAP levels were assessed at 30- and 180-days post-TIPS. While higher NfL levels (sHR 1.01, p = 0.036) were independently associated with post-TIPS OHE after adjusting for other risk factors, GFAP levels had no predictive ability. Consistently, only elevated NfL levels were associated with a higher risk of death/liver transplantation in multivariable analyses. Sequential measurements of NfL at 30 and 180 days after TIPS revealed that NfL levels remain constant until Day 30 followed by a decrease at day 180. Notably, GFAP levels did not change over time. Thus, NfL could be a valuable biomarker for identifying high-risk patients for post-TIPS HE.",

author = "Christian Labenz and Schleicher, \{Eva Maria\} and Myriam Meineck and Kabelitz, \{Martin A.\} and Ehrenbauer, \{Alena F.\} and Anja Tiede and Mauz, \{Jim B.\} and Sven Danneberg and Pitton, \{Michael Bernhard\} and Falk Steffen and Julia Weinmann-Menke and Galle, \{Peter Robert\} and Stefan Bittner and Felix L{\"u}ssi and Marquardt, \{Jens Uwe\} and Benjamin Maasoumy and Gairing, \{Simon Johannes\}",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s). MedComm published by Sichuan International Medical Exchange \& Promotion Association (SCIMEA) and John Wiley \& Sons Australia, Ltd.",

year = "2025",

month = nov,

doi = "10.1002/mco2.70475",

language = "English",

volume = "6",

journal = "MedComm",

issn = "2688-2663",

publisher = "John Wiley and Sons Inc",

number = "11",

}

Labenz, C, Schleicher, EM, Meineck, M, Kabelitz, MA, Ehrenbauer, AF, Tiede, A, Mauz, JB, Danneberg, S, Pitton, MB, Steffen, F, Weinmann-Menke, J, Galle, PR, Bittner, S, Lüssi, F, Marquardt, JU, Maasoumy, B & Gairing, SJ 2025, 'Neurofilament Light Chains in Serum Predict Post—Transjugular Intrahepatic Portosystemic Shunt Hepatic Encephalopathy', MedComm, Jg. 6, Nr. 11, e70475. https://doi.org/10.1002/mco2.70475

TY - JOUR

T1 - Neurofilament Light Chains in Serum Predict Post—Transjugular Intrahepatic Portosystemic Shunt Hepatic Encephalopathy

AU - Labenz, Christian

AU - Schleicher, Eva Maria

AU - Meineck, Myriam

AU - Kabelitz, Martin A.

AU - Ehrenbauer, Alena F.

AU - Tiede, Anja

AU - Mauz, Jim B.

AU - Danneberg, Sven

AU - Pitton, Michael Bernhard

AU - Steffen, Falk

AU - Weinmann-Menke, Julia

AU - Galle, Peter Robert

AU - Bittner, Stefan

AU - Lüssi, Felix

AU - Marquardt, Jens Uwe

AU - Maasoumy, Benjamin

AU - Gairing, Simon Johannes

PY - 2025/11

Y1 - 2025/11

N2 - Hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) insertion constitutes a frequent and severe complication. However, there is a lack of robust predictive biomarkers for post-TIPS HE, so far. This study evaluated the usefulness of neurofilament light chains (NfL) and glial fibrillary acidic protein (GFAP) in serum for predicting post-TIPS HE. Around 144 patients with cirrhosis from three centers were prospectively included and monitored for the occurrence of post-TIPS overt HE, liver transplantation, and death. Serum NfL and GFAP were evaluated before TIPS insertion using the single molecule array technology. In a subgroup of patients sequential NfL and GFAP levels were assessed at 30- and 180-days post-TIPS. While higher NfL levels (sHR 1.01, p = 0.036) were independently associated with post-TIPS OHE after adjusting for other risk factors, GFAP levels had no predictive ability. Consistently, only elevated NfL levels were associated with a higher risk of death/liver transplantation in multivariable analyses. Sequential measurements of NfL at 30 and 180 days after TIPS revealed that NfL levels remain constant until Day 30 followed by a decrease at day 180. Notably, GFAP levels did not change over time. Thus, NfL could be a valuable biomarker for identifying high-risk patients for post-TIPS HE.

AB - Hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) insertion constitutes a frequent and severe complication. However, there is a lack of robust predictive biomarkers for post-TIPS HE, so far. This study evaluated the usefulness of neurofilament light chains (NfL) and glial fibrillary acidic protein (GFAP) in serum for predicting post-TIPS HE. Around 144 patients with cirrhosis from three centers were prospectively included and monitored for the occurrence of post-TIPS overt HE, liver transplantation, and death. Serum NfL and GFAP were evaluated before TIPS insertion using the single molecule array technology. In a subgroup of patients sequential NfL and GFAP levels were assessed at 30- and 180-days post-TIPS. While higher NfL levels (sHR 1.01, p = 0.036) were independently associated with post-TIPS OHE after adjusting for other risk factors, GFAP levels had no predictive ability. Consistently, only elevated NfL levels were associated with a higher risk of death/liver transplantation in multivariable analyses. Sequential measurements of NfL at 30 and 180 days after TIPS revealed that NfL levels remain constant until Day 30 followed by a decrease at day 180. Notably, GFAP levels did not change over time. Thus, NfL could be a valuable biomarker for identifying high-risk patients for post-TIPS HE.

UR - https://www.scopus.com/pages/publications/105021110392

U2 - 10.1002/mco2.70475

DO - 10.1002/mco2.70475

M3 - Journal articles

AN - SCOPUS:105021110392

SN - 2688-2663

VL - 6

JO - MedComm

JF - MedComm

IS - 11

M1 - e70475

ER -

Neurofilament Light Chains in Serum Predict Post—Transjugular Intrahepatic Portosystemic Shunt Hepatic Encephalopathy

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