article published Marc Pawlitzki author Lars Masanneck author Laura Schlarbaum author 96697 Nicole Jankovic author Stefan Bittner author Falk Steffen author Jens Kuhle author Pascal Benkert author Jonathan Repple author Judith Bühlmeier author Anke Hinney author Johannes Hebebrand author Raphael Hirtz author Sven G. Meuth author Lars Libuda author 886820000-0003-1603-3133 Manuel Föcker author <jats:title>Abstract</jats:title> <jats:p> Serum neurofilament light chain (sNfL) and glial fibrillary acidic protein (GFAP) are biomarkers of neuroaxonal and astrocytic damage but remain understudied in adolescent psychiatric populations. This study investigated sNfL and GFAP levels in 412 adolescents diagnosed with anorexia nervosa (AN) ( <jats:italic>n</jats:italic>  = 52), depression ( <jats:italic>n</jats:italic>  = 237), and other psychiatric disorders ( <jats:italic>n</jats:italic>  = 123). We assessed their diagnostic utility, correlation with disease severity, and longitudinal changes during AN treatment. Biomarkers were measured using Single Molecule Array technology, with Z-scores derived from reference datasets. Compared to population norms, both biomarkers were elevated in AN (sNfL: 1.15 ± 1.17; GFAP: 1.50 ± 0.84) and in depression (sNfL: 0.34 ± 1.10; GFAP: 0.58 ± 1.00). Patients with AN showed significantly higher biomarker levels than those with depression or other psychiatric disorders; importantly, this distinction remained evident in sensitivity analyses restricted to underweight individuals with depression. In AN, sNfL levels correlated with baseline weight loss (β = −0.45, R² = 0.20) and declined significantly during treatment, while GFAP changes were less pronounced. Neither marker correlated with depressive symptom severity. Bootstrapped ROC analyses showed moderate-to-good discriminatory power (AUCs 0.70–0.84) for distinguishing AN from depression. These findings suggest that neuroaxonal and astrocytic stress is a component of adolescent psychopathology, particularly in AN. sNfL appears sensitive to starvation-related neurobiological changes, with levels normalizing alongside weight restoration. GFAP showed similar but less robust trends. Accordingly, the observed biomarker changes reflect more than underweight alone, supporting a potential role in differential diagnosis and treatment monitoring. </jats:p> https://ris.uni-paderborn.de/download/66849/66850/s41398-026-04347-1.pdf application/pdf Springer Science and Business Media LLC2026 eng 2158-318810.1038/s41398-026-04347-1 161 @article{Pawlitzki_Masanneck_Schlarbaum_Jankovic_Bittner_Steffen_Kuhle_Benkert_Repple_Bühlmeier_et al._2026, title={Exploring serum biomarkers in paediatric psychiatry: the impact of NfL and GFAP}, volume={16}, DOI={<a href="https://doi.org/10.1038/s41398-026-04347-1">10.1038/s41398-026-04347-1</a>}, number={1431}, journal={Translational Psychiatry}, publisher={Springer Science and Business Media LLC}, author={Pawlitzki, Marc and Masanneck, Lars and Schlarbaum, Laura and Jankovic, Nicole and Bittner, Stefan and Steffen, Falk and Kuhle, Jens and Benkert, Pascal and Repple, Jonathan and Bühlmeier, Judith and et al.}, year={2026} } Pawlitzki M, Masanneck L, Schlarbaum L, et al. Exploring serum biomarkers in paediatric psychiatry: the impact of NfL and GFAP. <i>Translational Psychiatry</i>. 2026;16(1). doi:<a href="https://doi.org/10.1038/s41398-026-04347-1">10.1038/s41398-026-04347-1</a> Pawlitzki, Marc, et al. “Exploring Serum Biomarkers in Paediatric Psychiatry: The Impact of NfL and GFAP.” <i>Translational Psychiatry</i>, vol. 16, no. 1, 431, Springer Science and Business Media LLC, 2026, doi:<a href="https://doi.org/10.1038/s41398-026-04347-1">10.1038/s41398-026-04347-1</a>. M. Pawlitzki, L. Masanneck, L. Schlarbaum, N. Jankovic, S. Bittner, F. Steffen, J. Kuhle, P. Benkert, J. Repple, J. Bühlmeier, A. Hinney, J. Hebebrand, R. Hirtz, S. G. Meuth, L. Libuda, M. Föcker, Translational Psychiatry 16 (2026). Pawlitzki, Marc, Lars Masanneck, Laura Schlarbaum, Nicole Jankovic, Stefan Bittner, Falk Steffen, Jens Kuhle, et al. “Exploring Serum Biomarkers in Paediatric Psychiatry: The Impact of NfL and GFAP.” <i>Translational Psychiatry</i> 16, no. 1 (2026). <a href="https://doi.org/10.1038/s41398-026-04347-1">https://doi.org/10.1038/s41398-026-04347-1</a>. M. Pawlitzki <i>et al.</i>, “Exploring serum biomarkers in paediatric psychiatry: the impact of NfL and GFAP,” <i>Translational Psychiatry</i>, vol. 16, no. 1, Art. no. 431, 2026, doi: <a href="https://doi.org/10.1038/s41398-026-04347-1">10.1038/s41398-026-04347-1</a>. Pawlitzki, M., Masanneck, L., Schlarbaum, L., Jankovic, N., Bittner, S., Steffen, F., Kuhle, J., Benkert, P., Repple, J., Bühlmeier, J., Hinney, A., Hebebrand, J., Hirtz, R., G. Meuth, S., Libuda, L., &#38; Föcker, M. (2026). Exploring serum biomarkers in paediatric psychiatry: the impact of NfL and GFAP. <i>Translational Psychiatry</i>, <i>16</i>(1), Article 431. <a href="https://doi.org/10.1038/s41398-026-04347-1">https://doi.org/10.1038/s41398-026-04347-1</a> 668492026-08-26T08:23:11Z2026-08-26T08:26:16Z