The chemokine CXCL13 in acute neuroborreliosis

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 (NB, n= 28), systemic
borreliosis (SB, n=9), Guillain-Barre 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 from patients with
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 to other neurological diseases (p<0.001). Using ROC analysis, 337 ng/g
was determined as 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 one week. In
untreated patients, CSF CXCL13 was elevated in patients with a short duration of
disease. Borrelia burgdorferi antibody index (BB-AI) showed no significant
(p=0.356) change over follow-up.

CONCLUSIONS: Our study confirms the relevance
of CXCL13 as a diagnostic biomarker of NB. It 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.

http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=19965843&retmode=ref&cmd=prlinks
PMID: 19965843  [PubMed – as supplied by publisher]

J Neurol Neurosurg Psychiatry. 2009 Dec 3; [Epub ahead of print]

The chemokine CXCL13 in acute neuroborreliosis.

Senel M, Rupprecht TA, Tumani H, Pfister HW, Ludolph AC, Brettschneider J.

University of Ulm, Department of Neurology, Germany;