Cerebrospinal fluid CXCL13 in multiple sclerosis: a suggestive prognostic marker for the disease course
Cerebrospinal fluid CXCL13 in multiple sclerosis: a suggestive prognostic marker for the disease course
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DOI：
10.1177/1352458510389102
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发表时间：
2011-03-01
影响因子：
5.8
通讯作者：
Olsson, Tomas
中科院分区：
文献类型：
--
作者：
Khademi, Mohsen;Kockum, Ingrid;Olsson, Tomas
背景：CXCL13 是一种有效的 B 细胞化学引诱剂，在多发性硬化症 (MS) 期间，脑脊液 (CSF) 中的水平升高，并且与 MS 活性标志物相关。有效治疗后水平会降低。目的：在这里，我们在大量临床材料中验证了 CSF CXCL13 作为 MS 生物标志物的潜在作用，这些临床材料大部分是在早期诊断检查中收集的。方法：通过 ELISA 在 837 名受试者中测量了 CXCL13：复发缓解型 MS (RRMS；n = 323)、继发进展型 MS (SPMS；n = 40)、 原发进展型多发性硬化症 (PPMS；n = 24)、临床孤立综合征 (CIS；n = 79)、其他神经系统疾病 (OND；n = 181)、有炎症或病毒/细菌感染迹象的 OND (iOND；n = 176) 和健康对照 (n = 14)。 结果：与所有纳入组相比，患有病毒/细菌感染的受试者的 CXCL13 水平极高 （p < 0.0001）。与其余对照 (p < 0.0001) 和 CIS (p < 0.01) 相比，CXCL13 在 MS 方面显着更高。 CXCL13 与复发率、扩展残疾状态量表 (EDSS) 的结果以及 MRI 检测到的病变数量之间存在显着的正相关性。 CXCL13 在 CIS 转化为临床明确 MS 时增加 (p < 0.001)。与 OCB 阴性 CIS 或 MS 相比，寡克隆免疫球蛋白带 (OCB) 阳性 CIS 或 MS 的 CXCL13 水平显着升高（分别为 p < 0.001 和 p < 0.0001）。结论：CXCL13 与 RRMS 疾病恶化和不良预后相关。 CXCL13 的增加并不是 MS 所特有的，因为病毒/细菌感染的受试者表现出更高的水平。高水平预示 CIS 转化为 MS。我们建议，CSF CXCL13 的测量可以成为 MS 诊断和预后检查的一部分，并有助于未来的治疗决策。
Background: Levels of CXCL13, a potent B-cell chemoattractant, are elevated in the cerebrospinal fluid (CSF) during multiple sclerosis (MS) and are associated with markers of MS activity. Levels decrease upon effective treatments.Objective: Here we validate the potential role of CSF CXCL13 as a biomarker for aspects of MS in a large amount of clinical material, the majority collected at early diagnostic work-up.Methods: CXCL13 was measured by ELISA in 837 subjects: relapsing-remitting MS (RRMS; n = 323), secondary progressive MS (SPMS; n = 40), primary progressive MS (PPMS; n = 24), clinically isolated syndrome (CIS; n = 79), other neurological diseases (ONDs; n = 181), ONDs with signs of inflammation or viral/bacterial infections (iONDs; n = 176) and healthy controls (n = 14).Results: Subjects with viral/bacterial infections had extremely high CXCL13 levels compared to all included groups (p < 0.0001). CXCL13 was otherwise significantly higher in MS compared to the remaining controls (p < 0.0001), and CIS (p < 0.01). A significant and positive correlation between CXCL13 and relapse rate, the results obtained for the Expanded Disability Status Scale (EDSS) and the number of lesions detected by MRI was demonstrated. CXCL13 was increased in CIS conversion to clinically definite MS (p < 0.001). Oligoclonal immunoglobulin band (OCB)-positive CIS or MS had significantly increased CXCL13 levels compared to OCB-negative CIS or MS (p < 0.001 and p < 0.0001, respectively).Conclusion: CXCL13 was associated with disease exacerbations and unfavourable prognosis in RRMS. Increased CXCL13 was not specific for MS since subjects with viral/bacterial infections exhibited even higher levels. High levels predicted CIS conversion to MS. We suggest that measurement of CSF CXCL13 can be part of the armamentarium in the diagnostic and prognostic work-up in MS and be of help in future treatment decisions.