Chitinase-3-like-protein-1 (CHI3L1) is a potential new biomarker for the progression of multiple sclerosis (MS) in patients, according to a study published in Neurological Sciences.

Patients with MS had higher levels of CHI3L1 in their cerebrospinal fluid compared to healthy controls (P <.001). CHI3L1 levels were also significantly positively correlated with several clinical parameters during the study. Increased levels of CHI3L1 were correlated with duration of MS (P <.001; r =.608), number of attacks (P =.001; r=.460), and Expanded Disability Status Scale (EDSS) scores (P >.001; r =.730).

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Cognitive impairment, measured through Mini-Mental State Examination and the Brief International Cognitive Assessment for Multiple Sclerosis, was also strongly correlated with CHI3L1 levels (P =.001 for both). 

Positive correlations were also observed between CHI3L1 levels and radiological parameters, including the presence of brain atrophy, T2 lesion number, and brain black holes (P <.001 for all). Compressed sensing MRI also revealed correlations between CHI3L1 levels and the presence of demyelinating lesions and spinal cord atrophy (P =.001 for both).

The average levels of CHI3L1 were significantly higher in patients with MS (165.29 ng/mL) than those in healthy controls (28.46 ng/mL; P <.001). Subgroup analysis also found statistical differences in CHI3L1 levels between the subtypes of MS.

The mean CHI3L1 level in patients with relapsing-remitting MS (RRMS) was 107.37 ng/mL compared to 244.27 ng/mL in patients with progressive MS (PMS; P <.001). No significant difference in CHI3L1 level was observed between the 2 types of progressive MS (primary progressive MS [PPMS] and secondary progressive MS [SPMS]), however (means, 256 ng/mL vs 239.88 ng/mL; P =.802).

“These findings suggest that CHI3L1 could be a useful tool for monitoring disease progression and predicting outcomes in patients with MS. However, further research is needed to fully establish the clinical utility of CHI3L1 as a biomarker in MS,” the authors wrote.

A total of 52 patients with MS and 30 healthy controls were recruited for the study. The control group was equally represented in terms of gender (50% female), while the MS group had a higher percentage of female patients (76.9% female). Of the 52 patients with MS, 30 had RRMS, while 22 had PMS. 


Talaat F, Abdelatty S, Ragaie C, Dahshan A. Chitinase-3-like 1-protein in CSF: a novel biomarker for progression in patients with multiple sclerosis. Neurol Sci. Published online March 29, 2023. doi:10.1007/s10072-023-06764-2