Beyond LNB: Real life data on occurrence and extent of CSF CXCL13 in neuroinflammatory diseases
Georg Pilz1, Regina Steger2, Peter Wipfler1
1Department of Neurology, Paracelsus Medical University, Salzburg, Austria.
Insights
CXCL13 elevations in cerebrospinal fluid (CSF) are common in many neuroinflammatory diseases, not just Lyme neuroborreliosis. This finding suggests broader CNS immune activation beyond specific infections.
Area of Science:
- Neuroimmunology
- Infectious Diseases
- Cerebrospinal Fluid Analysis
Background:
- Cerebrospinal fluid (CSF) CXCL13 elevations are primarily associated with Lyme neuroborreliosis (LNB).
- The presence and significance of CXCL13 in other neuroinflammatory conditions remain less understood.
- Investigating CXCL13 beyond LNB is crucial for understanding CNS immune responses.
Purpose of the Study:
- To determine the occurrence and extent of CSF CXCL13 elevations in a diverse cohort of neuroinflammatory diseases.
- To assess if CXCL13 elevation is specific to Lyme neuroborreliosis or indicative of broader central nervous system (CNS) inflammation.
- To explore the implications of CXCL13 as a potential biomarker for CNS immune activation.
Main Methods:
- Analysis of CSF samples from 180 in-patients with CSF pleocytosis between March 2016 and March 2017.
- Categorization of patients into groups: pyogenic CNS infections, aseptic meningoencephalitis, neuroimmunological diseases, and reactive pleocytosis.
- Quantification of CXCL13 levels in CSF across different neuroinflammatory disease categories.
Main Results:
- CXCL13 elevation was observed in the majority of patients with neuroinflammatory diseases studied.
- The extent of CXCL13 elevation varied across different conditions.
- Elevated CXCL13 levels were not exclusive to Lyme neuroborreliosis, indicating its presence in various CNS inflammatory states.
Conclusions:
- CXCL13 elevation in CSF is a common finding in a wide spectrum of neuroinflammatory diseases.
- The broad occurrence of CXCL13 suggests it reflects general CNS immune activation rather than being a specific marker for LNB.
- Further research is needed to elucidate the precise role of CXCL13 in the pathogenesis of diverse neuroinflammatory conditions.
Abstract:
To evaluate occurrence and extent of CSF CXCL13 elevations beyond Lyme neuroborreliosis, we investigated CXCL13 in an unselected patient cohort with neuroinflammatory disease. From March 2016 to March 2017, 180 in-patients with CSF pleocytosis were categorized into following groups: pyogenic CNS infections, aseptic meningoencephalitis, neuroimmunological diseases, and reactive pleocytosis. We provide evidence that CXCL13 elevation occurs at variable extent in the majority of neuroinflammatory diseases. The exact role of CXCL13 in CSF is elusive, but the broad occurrence in neuroinflammation points at CNS immune activation, which is not exclusive for LNB.
