The chemokine CXCL13 in acute neuroborreliosis

J Neurol Neurosurg Psychiatry. 2010 Aug;81(8):929-33. doi: 10.1136/jnnp.2009.195438. Epub 2009 Dec 3.

Abstract

Objective: Recent studies have suggested an important role of the B cell chemoattractant CXCL13 in acute neuroborreliosis (NB). Our aim was to confirm the diagnostic role of CXCL13 and to evaluate its relevance as a therapy response and disease activity marker in NB.

Methods: CXCL13 was measured in cerebrospinal fluid (CSF) and serum of patients with NB (n=28), systemic borreliosis (SB, n=9), Guillain-Barré syndrome (GBS, n=11), Bell's palsy (BP, n=19), other cranial nerve palsies (CNP, n=5), cephalgia (C, n=20), bacterial CNS infections (B-CNS-I, n=16) and viral CNS infections (V-CNS-I, n=18). For follow-up studies, serial sample pairs were evaluated from 25 patients with NB (n=56), 11 with B-CNS-I (n=25) and 14 with V-CNS-I (n=36).

Results: CSF-CXCL13 was significantly elevated in NB compared with other neurological diseases (p<0.001). Using receiver operating characteristic analysis, 337 ng/g was determined as a cut-off with a sensitivity of 96.4% and a specificity of 96.9%. Of all the parameters investigated, CSF CXCL13 showed the fastest response to antibiotic therapy, decreasing significantly (p=0.008) within 1 week. In untreated patients, CSF CXCL13 was elevated in patients with a short duration of disease. Borrelia burgdorferi antibody index showed no significant (p=0.356) change over follow-up.

Conclusions: The study confirms the relevance of CXCL13 as a diagnostic biomarker of NB and suggests that CSF CXCL13 in NB is linked to duration of disease and could be a marker of disease activity and response to antibiotic therapy.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Antigens, Bacterial / analysis
  • Biomarkers
  • Borrelia burgdorferi / immunology
  • Chemokine CXCL13 / blood
  • Chemokine CXCL13 / cerebrospinal fluid*
  • Enzyme-Linked Immunosorbent Assay
  • Humans
  • Lyme Neuroborreliosis / diagnosis*
  • Lyme Neuroborreliosis / drug therapy
  • Lyme Neuroborreliosis / metabolism
  • Nervous System Diseases / cerebrospinal fluid
  • Nervous System Diseases / diagnosis
  • Spinal Puncture
  • Virus Diseases / diagnosis

Substances

  • Anti-Bacterial Agents
  • Antigens, Bacterial
  • Biomarkers
  • Chemokine CXCL13