New insights into neurofilament and cytokine biomarkers: A narrative review

Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy are immune-mediated neuropathies that often present with clinical uncertainty. Early and accurate diagnosis of these conditions remains a persistent challenge, as does monitoring disease progression and treatment response. In recent years, biomarkers such as neurofilament light chain and inflammatory cytokines have shown promise in helping clinicians better understand and manage these disorders. Moreover, their use in practice is still evolving. This review examines the current evidence on neurofilament light chain and key cytokines such as interleukin-6, tumor necrosis factor-α, interleukin-8, and interleukin-10 in the context of Guillain–Barré syndrome and chronic inflammatory demyelinating polyneuropathy. We discuss their potential roles in diagnosis, prognosis, and treatment guidance. Elevated neurofilament light chain levels reflect axonal injury and are associated with greater disease severity, poorer treatment response, and worse outcomes. Cytokine profiles reveal the characteristics of the inflammatory environment. For example, elevated interleukin-6 or suppressed interleukin-10 may help identify patients likely to benefit from targeted immunotherapy. Interleukin-6 in particular stands out due to its availability in standard clinical labs, making it a realistic candidate for near-term integration into care. Looking ahead, the use of artificial intelligence to interpret subtle shifts in biomarker levels over time could open the door to earlier intervention even before symptoms flare. Biomarker-guided strategies hold the potential to reshape how we approach Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy shifting from reactive care to a more personalized, proactive model. To realize this shift, future clinical trials must focus on validating these markers in real-world settings. Through the thoughtful integration of biomarkers, imaging, and artificial intelligence, we may soon enter a new era of precision medicine in neurology, one that meets patients where they are, and anticipates where their disease is going.