Peripherin is a biomarker of axonal damage in peripheral nervous system disease.

This article focuses on the development and evaluation of serum peripherin as a novel, specific biomarker for peripheral nerve axonal damage. Peripherin, a type III intermediate filament protein predominantly expressed in peripheral nerve axons, was measured using a newly developed ultrasensitive single molecule array (Simoa) immunoassay. In clinical cohorts, serum peripherin levels were significantly elevated in patients with Guillain-Barré syndrome (GBS) compared to chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), multiple sclerosis, dementia, and healthy controls, with peripherin showing greater specificity for peripheral nervous system injury than neurofilament light chain (NfL). Longitudinal analysis revealed that peripherin levels in GBS peaked earlier than NfL and correlated with disease activity, suggesting its potential utility in diagnosis and monitoring of acute peripheral neuropathies.