Article Text

This article has a correction. Please see:

Download PDFPDF
The chemokine CXCL13 in acute neuroborreliosis
  1. Makbule Senel1,
  2. Tobias A Rupprecht2,
  3. Hayrettin Tumani1,
  4. Hans W Pfister2,
  5. Albert C Ludolph1,
  6. Johannes Brettschneider1
  1. 1Department of Neurology, University of Ulm, Ulm, Germany
  2. 2Department of Neurology, Ludwig-Maximilians-University of Munich-Grosshadern, Munich, Germany
  1. Correspondence to Dr Hayrettin Tumani, Department of Neurology, University of Ulm, Oberer Eselsberg 45, Ulm 89081, Germany; hayrettin.tumani{at}


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 (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 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 with other neurological diseases (p<0.001). Using receiver operating characteristic analysis, 337 ng/g was determined as a 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 1 week. In untreated patients, CSF CXCL13 was elevated in patients with a short duration of disease. Borrelia burgdorferi antibody index showed no significant (p=0.356) change over follow-up.

Conclusions The study confirms the relevance of CXCL13 as a diagnostic biomarker of NB and 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.

  • Neuroborreliosis
  • chemokines
  • CXCL13
  • cerebrospinal fluid
  • disease activity
  • borrelia
  • CSF

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Ethics committee, University of Ulm.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Linked Articles

  • PostScript
    BMJ Publishing Group Ltd