Intrathecally produced CXCL13: A predictive biomarker in multiple sclerosis
Krista D DiSano1, Francesca Gilli1, Andrew R Pachner1
1Department of Neurology, Geisel School of Medicine & Dartmouth-Hitchcock Medical Center, Lebanon, USA.
Summary
The CXCL13 index shows promise as a biomarker for predicting future disease activity in Multiple Sclerosis (MS) patients. It outperforms other markers like OCBs and CSF NfL, especially when combined with CSF NfL.
Area of Science:
- Neurology
- Immunology
- Biomarker Discovery
Background:
- Multiple Sclerosis (MS) management requires improved biomarkers for clinicians.
- Current prognostic tools for MS disease activity have limitations.
Purpose of the Study:
- To evaluate the predictive value of the CXCL13 index against established biomarkers (OCBs, CSF NfL) for future MS disease activity.
- To assess biomarker performance across different MS subtypes and disease courses.
Main Methods:
- Matched serum and cerebrospinal fluid (CSF) samples were collected from MS patients and controls.
- CXCL13 and CSF NfL levels were measured using Luminex and ELISA.
- CXCL13 index and CSF/serum ratios were calculated and analyzed.
- Electronic medical records were used to track diagnoses and disease activity post-lumbar puncture.
Main Results:
- The CXCL13 index demonstrated the highest predictive accuracy (AUC=0.82) for future MS disease activity.
- CXCL13 index was significantly elevated in patients with active MS compared to inactive MS.
- CXCL13 index surpassed OCBs and CSF NfL in sensitivity, specificity, and predictive values.
- Combining CXCL13 index with CSF NfL improved prediction of MS disease activity.
Conclusions:
- The CXCL13 index is a highly effective candidate prognostic biomarker for predicting disease activity in Multiple Sclerosis.
- This biomarker holds potential for enhancing MS disease management strategies.
