{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T22:13:54Z","timestamp":1789424034646,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003042","name":"Else Kr\u00f6ner-Fresenius-Stiftung","doi-asserted-by":"publisher","award":["TransMed Jumpstart Program"],"award-info":[{"award-number":["TransMed Jumpstart Program"]}],"id":[{"id":"10.13039\/501100003042","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003042","name":"Else Kr\u00f6ner-Fresenius-Stiftung","doi-asserted-by":"publisher","award":["2019_A72"],"award-info":[{"award-number":["2019_A72"]}],"id":[{"id":"10.13039\/501100003042","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["213904703"],"award-info":[{"award-number":["213904703"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["490846870"],"award-info":[{"award-number":["490846870"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017694","name":"Hermann und Lilly Schilling-Stiftung f\u00fcr Medizinische Forschung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017694","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Purpose<\/jats:title><jats:p>Management of autoimmune encephalitis (AE) is challenging due to a lack of reliable biomarkers. We here assess the combination of glial fibrillary acid protein (GFAP) and neurofilament (NfL) as biomarkers for diagnosis and disease monitoring of AE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>GFAP and NfL CSF levels (cGFAP, cNfL) of 42 AE patients were correlated with CSF markers of neuroinflammation. NfL\/GFAP ratios were compared between patients with stable and active AE, stable and active multiple sclerosis (MS), and patients undergoing diagnostic lumbar puncture without evident pathological alterations (controls).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In patients with AE, cGFAP levels showed strong correlations with albumin and IgG quotients and moderate correlations with CSF cell count; cNfL levels showed weak correlations with albumin quotients. cGFAP and cNfL levels showed no significant differences between patients with and without epileptic activity or inflammatory MRI lesions. Both sNfL and sGFAP correlated with the Clinical Assessment Scale in Autoimmune Encephalitis. Compared to NfL or GFAP alone, the NfL\/GFAP ratio from CSF or serum led to a clearer separation of AE from MS patients and controls. Furthermore, serum NfL\/GFAP ratios better discriminated active from stable AE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>cGFAP levels indicate intrathecal inflammatory processes in patients with active AE to a stronger degree than cNfL levels. Serum NfL\/GFAP ratios recognize active AE, suggesting this ratio identifies AE patients with CNS\u2010compartmentalized neuronal injury (autoantibody\u2010mediated or cytotoxic) behind a relatively intact blood\u2013brain barrier. Our findings indicate that the NfL\/GFAP ratio can function as a blood\u2010based biomarker, aiding clinicians with diagnosis and disease management of AE.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.70207","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T13:01:54Z","timestamp":1748005314000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Glial Fibrillary Acid Protein Reflects Disease Activity in Autoimmune Encephalitis"],"prefix":"10.1111","volume":"32","author":[{"given":"Johannes","family":"Piepgras","sequence":"first","affiliation":[{"name":"Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine\u2010Main Neuroscience Network (rmn2) University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1767-4936","authenticated-orcid":false,"given":"Marlene L.","family":"Piepgras","sequence":"additional","affiliation":[{"name":"Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Falk","family":"Steffen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine\u2010Main Neuroscience Network (rmn2) University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Ehrhardt","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin A.","family":"Schaller\u2010Paule","sequence":"additional","affiliation":[{"name":"Department of Neurology Goethe University, University Hospital Frankfurt  Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yavor","family":"Yalachkov","sequence":"additional","affiliation":[{"name":"Department of Neurology Goethe University, University Hospital Frankfurt  Frankfurt am Main Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frauke","family":"Zipp","sequence":"additional","affiliation":[{"name":"Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine\u2010Main Neuroscience Network (rmn2) University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2179-3655","authenticated-orcid":false,"given":"Stefan","family":"Bittner","sequence":"additional","affiliation":[{"name":"Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine\u2010Main Neuroscience Network (rmn2) University Medical Center of the Johannes Gutenberg University Mainz  Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.4251"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000087"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A5086"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2020.102807"},{"issue":"8","key":"e_1_2_9_6_1","doi-asserted-by":"crossref","DOI":"10.1002\/brb3.1354","article-title":"Cerebrospinal Fluid Light and Heavy Neurofilament Level Increased in Anti\u2010N\u2010Methyl\u2010d\u2010Aspartate Receptor Encephalitis","volume":"9","author":"Li J.","year":"2019","journal-title":"Brain and Behavior: A Cognitive Neuroscience Perspective"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000207221"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12942"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.719432"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-019-09306-z"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000200021"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011937"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-33158-8"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-67934-2"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.5250"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00401-9"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.14631"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12987-023-00418-3"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1159\/000530437"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17132"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17713"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2018.07.010"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16742"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008160"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2021.3671"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.70207","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T12:01:32Z","timestamp":1748347292000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.70207"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1111\/ene.70207"],"URL":"https:\/\/doi.org\/10.1111\/ene.70207","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5]]},"assertion":[{"value":"2024-11-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70207"}}