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The chemokine CXCL13 in acute neuroborreliosis
  1. Makbule Senel1,
  2. Tobias A Rupprecht2,
  3. Hayrettin Tumani1,
  4. Hans Walter Pfister2,
  5. Albert C Ludolph1,
  6. Johannes Brettschneider1,*
  1. 1 University of Ulm, Department of Neurology, Germany;
  2. 2 Ludwig-Maximilians-University of Munich-Grosshadern, Department of Neurology, Germany
  1. Correspondence to: Johannes Brettschneider, Neurology, University of Ulm, Oberer Eselsberg 45, Ulm, 89081, Germany; johannes.brettschneider{at}uni-ulm.de

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 (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 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.

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