Cerebrospinal fluid levels of CXCL13 are elevated in neuromyelitis optica

Background: B cells are believed to play an important role in the pathogenesis of NMO. Chemokine (C-X-C motif) ligand 13 (CXCL13), the most potent B-cell chemoattractant, is a chemokine which is critical for secondary lymphoid tissue development and for B-cell migration. Concentration of CXCL13 in cerebral spinal fluid (CSF) is elevated in patients with multiple sclerosis (MS). However, whether levels of CSF CXCL13 are elevated in NMO patients still remain unknown. Objective: To measure the CSF concentration of CXCL13 in NMO patients, and to determine its relationship with NMO disease activity. Methods: CSF CXCL13 was measured by an enzyme-linked immunosorbent assay (ELISA) in NMO (n = 22), MS (n = 18) patients and controls (CTLs) (n = 12). Results: CSF CXCL13 levels in NMO were notable higher than MS (p = 0.015) and CTLs (p<0.001), and were related to the NMO disease activity indicated by relapse rate and Expanded Disability Status Scale (EDSS) scores. NMO Patients with the higher relapse rates exhibited the higher CXCL13 concentrations in their CSF; and a trend of increased disease disability with increased CSF CXCL13 level was revealed. The CSF CXCL13 concentrations seemed to associate with CSF white blood cell counting, total protein concentration in NMO subgroup, thought did not quite reach statistical significance (WBC, p = 0.473; TP, p = 0.276). Conclusions: The concentration of CSF CXCL13 was elevated in NMO patients, and correlated with NMO activity. (C) 2011 Elsevier B.V. All rights reserved.