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.