Evidence map›Paper›PMID 40875959›Full record

ArticleNeurology(R) neuroimmunology & neuroinflammation2025

Stool Glial Fibrillary Acidic Protein Is Elevated in Progressive Multiple Sclerosis.

Luke A Schwerdtfeger, Federico Montini, Martina Antonini Cencicchio, Jonathan R Christenson, Bonnie I Glanz, Marika Falcone, Massimo Filippi, Laura M Cox, Tanuja Chitnis, Howard L Weiner

Abstract read
In one paragraph

Article in Neurology(R) neuroimmunology & neuroinflammation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Enteric glia, neuropeptides, and Parkinson's: impacts of calcitonin gene-related peptide on gut alpha synuclein.American journal of physiology. Gastrointestinal and liver physiology · 2026
    Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Luke A SchwerdtfegerAnn Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.ORCID 0000-0001-8030-3164
Federico MontiniAnn Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.ORCID 0000-0002-8367-0741
Martina Antonini CencicchioAutoimmune Pathogenesis Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; and.
Jonathan R ChristensonAnn Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.ORCID 0009-0006-1333-4896
Bonnie I GlanzAnn Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.ORCID 0000-0002-4344-3456
Marika FalconeAutoimmune Pathogenesis Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; and.
Massimo FilippiNeurology Unit, Neurorehabilitation Unit, Neurophysiology Service, and Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.ORCID 0000-0002-5485-0479
Laura M CoxAnn Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Tanuja ChitnisAnn Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.ORCID 0000-0002-9897-4422
Howard L WeinerAnn Romney Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.ORCID 0000-0003-0203-9681

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe gut microbiota and altered intestinal physiology have been implicated in multiple sclerosis (MS). Enteric glial cells regulate enteric nervous and immune function and express glial fibrillary acidic protein (GFAP) and S100β. Serum GFAP and neurofilament light chain can predict disease worsening; however, no clear markers differentiate relapsing from progressive disease.

methodsTo investigate enteric glial function in MS, we measured stool GFAP (st-GFAP) using an enzyme-linked immunosorbent assay in 31 healthy controls (HCs), 77 patients with relapsing remitting MS (RRMS), and 53 patients with progressive MS (ProgMS). Participants underwent clinical follow-up at 2 and 5 years after stool donation.

resultsWe found higher st-GFAP levels in patients with ProgMS compared with those with RRMS and HCs. St-GFAP was positively correlated with baseline Expanded Disability Status Scale (EDSS) score, 25-foot walk time, and an increased EDSS score at 2 and 5 years. We found enteric glial hyperplasia in the colonic mucosa of a patient with primary progressive MS, as indicated by GFAP and S100β immunoreactivity, an effect not observed in duodenum tissue in patients with RRMS from our Milan cohort. St-GFAP in patients with ProgMS was negatively associated with DISCUSSION: These exploratory data indicate an altered enteric glial phenotype in patients with ProgMS and suggest that st-GFAP may be a prognostic biomarker.

Indexed as

FecesGlial Fibrillary Acidic ProteinMultiple Sclerosis, Chronic ProgressiveMultiple Sclerosis, Relapsing-RemittingAdultBiomarkersDisease ProgressionFemaleFollow-Up StudiesHumansMaleMiddle AgedBiomarkersGFAP protein, humanGlial Fibrillary Acidic Protein

Identifiers

PMID40875959
PMCPMC12396743

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.