CHST6 and amyotrophic lateral sclerosis: In line with our finding of CHIT1 being negatively correlated with the MoCA scores, chitinases including CHIT1 have emerged as biomarkers in neurological disorders including amyotrophic lateral sclerosis (ALS), as their levels correlate with disease activity and progression, likely reflecting microglia/macrophage activation.85, 86, 87 In addition, levels of proteins such as CHST6 correlate well with disease progression, as measured by the UPDRS, especially UPDRS III (Figures 6A and S4).