Prospective study on the chemokine CXCL13 in neuroborreliosis and other aseptic neuroinfections

The study evaluates the clinical significance of CXCL13 (leukocyte chemoattractant synthesized in CSF) in Lyme neuroborreliosis (LNB) and other aseptic CNS infections. 244 patients with symptoms of neuroinfection and/or LNB were divided into groups: A - patients with LNB-positive antibodies in serum and CSF (96) or CSF only (14); B - patients with aseptic non-borrelial neuroinfections (82); C - negative controls (52). Group A was divided into A1-A4 according to pleocytosis in CSF and AIIgG positivity. The highest CSF CXCL13 concentrations (max. 81,287.60 pg/ml; median 1766.90 pg/ml) were in A1 (positive AI, pleocytosis) and A3 (negative AIIgG, pleocytosis; max. 7201,60 pg/ml, median 56.22 pg/ml). A2 ( positive AI without pleocytosis) and A4 (negative Al without pleocytosis) had low CXCL13 levels - A2 max. 650.50 pg/ml (median < 7.80 pg/ml); A4 max. 118.56 pg/ml (median < 7.8 pg/ml). In B the median was 28.10 pg/ml (max. 595.87 pg/ml). In C the CXCL13 concentrations were the lowest (max. 83.83 pg/ml; median < 7.80 pg/ml). The lowest cut-off was 29 pg/ml (sensitivity 90.0%, specificity 72.2%), the highest one 400 pg/ml (sensitivity 59.6%, specificity 94.0%). The group differences of serum CXCL13 were insignificant. The highest concentrations were at the beginning of the disease. In LNB CXCL13 correlates better with the CSF pleocytosis than AI positivity. (C) 2016 Elsevier B.V. All rights reserved.