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Cerebrospinal fluid CXCL13 in Lyme neuroborreliosis and asymptomatic HIV infection

BACKGROUND: It has been suggested that cerebrospinal fluid (CSF) CXCL13 is a diagnostic marker of Lyme neuroborreliosis (LNB), as its levels have been shown to be significantly higher in LNB than in several other CNS infections. Levels have also been shown to decline after treatment with intravenous...

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Autores principales: Bremell, Daniel, Mattsson, Niklas, Edsbagge, Mikael, Blennow, Kaj, Andreasson, Ulf, Wikkelsö, Carsten, Zetterberg, Henrik, Hagberg, Lars
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546953/
https://www.ncbi.nlm.nih.gov/pubmed/23294475
http://dx.doi.org/10.1186/1471-2377-13-2
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author Bremell, Daniel
Mattsson, Niklas
Edsbagge, Mikael
Blennow, Kaj
Andreasson, Ulf
Wikkelsö, Carsten
Zetterberg, Henrik
Hagberg, Lars
author_facet Bremell, Daniel
Mattsson, Niklas
Edsbagge, Mikael
Blennow, Kaj
Andreasson, Ulf
Wikkelsö, Carsten
Zetterberg, Henrik
Hagberg, Lars
author_sort Bremell, Daniel
collection PubMed
description BACKGROUND: It has been suggested that cerebrospinal fluid (CSF) CXCL13 is a diagnostic marker of Lyme neuroborreliosis (LNB), as its levels have been shown to be significantly higher in LNB than in several other CNS infections. Levels have also been shown to decline after treatment with intravenous ceftriaxone, but levels after treatment with oral doxycycline have previously not been studied. Like Borrelia burgdorferi, HIV also has neurotropic properties. Elevated serum CXCL13 concentrations have been reported in HIV patients, but data on CSF levels are limited. METHODS: We longitudinally analysed CSF CXCL13 concentrations in 25 LNB patients before and after oral doxycycline treatment. Furthermore, we analysed CSF CXCL13 concentrations in 16 untreated LNB patients, 27 asymptomatic untreated HIV-1 infected patients and 39 controls with no signs of infectious or inflammatory disease. RESULTS: In the longitudinal LNB study, initially high CSF CXCL13 levels declined significantly after doxycycline treatment, which correlated to a decreased CSF mononuclear cell count. In the cross-sectional study, all the LNB patients had CSF CXCL13 levels elevated above the lowest standard point of the assay (7.8 pg/mL), with a median concentration of 500 pg/mL (range 34–11,678). Of the HIV patients, 52% had elevated CSF CXCL13 levels (median 10 pg/mL, range 0–498). There was a clear overlap in CSF CXCL13 concentrations between LNB patients and asymptomatic HIV patients. All but one of the 39 controls had CSF CXCL13 levels below 7.8 pg/mL. CONCLUSIONS: We confirm previous reports of highly elevated CSF CXCL13 levels in LNB patients and that these levels decline after oral doxycycline treatment. The same pattern is seen for CSF mononuclear cells. CSF CXCL13 levels are elevated in neurologically asymptomatic HIV patients and the levels overlap those of LNB patients. The diagnostic value of CSF CXCL13 in LNB remains to be established.
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spelling pubmed-35469532013-01-17 Cerebrospinal fluid CXCL13 in Lyme neuroborreliosis and asymptomatic HIV infection Bremell, Daniel Mattsson, Niklas Edsbagge, Mikael Blennow, Kaj Andreasson, Ulf Wikkelsö, Carsten Zetterberg, Henrik Hagberg, Lars BMC Neurol Research Article BACKGROUND: It has been suggested that cerebrospinal fluid (CSF) CXCL13 is a diagnostic marker of Lyme neuroborreliosis (LNB), as its levels have been shown to be significantly higher in LNB than in several other CNS infections. Levels have also been shown to decline after treatment with intravenous ceftriaxone, but levels after treatment with oral doxycycline have previously not been studied. Like Borrelia burgdorferi, HIV also has neurotropic properties. Elevated serum CXCL13 concentrations have been reported in HIV patients, but data on CSF levels are limited. METHODS: We longitudinally analysed CSF CXCL13 concentrations in 25 LNB patients before and after oral doxycycline treatment. Furthermore, we analysed CSF CXCL13 concentrations in 16 untreated LNB patients, 27 asymptomatic untreated HIV-1 infected patients and 39 controls with no signs of infectious or inflammatory disease. RESULTS: In the longitudinal LNB study, initially high CSF CXCL13 levels declined significantly after doxycycline treatment, which correlated to a decreased CSF mononuclear cell count. In the cross-sectional study, all the LNB patients had CSF CXCL13 levels elevated above the lowest standard point of the assay (7.8 pg/mL), with a median concentration of 500 pg/mL (range 34–11,678). Of the HIV patients, 52% had elevated CSF CXCL13 levels (median 10 pg/mL, range 0–498). There was a clear overlap in CSF CXCL13 concentrations between LNB patients and asymptomatic HIV patients. All but one of the 39 controls had CSF CXCL13 levels below 7.8 pg/mL. CONCLUSIONS: We confirm previous reports of highly elevated CSF CXCL13 levels in LNB patients and that these levels decline after oral doxycycline treatment. The same pattern is seen for CSF mononuclear cells. CSF CXCL13 levels are elevated in neurologically asymptomatic HIV patients and the levels overlap those of LNB patients. The diagnostic value of CSF CXCL13 in LNB remains to be established. BioMed Central 2013-01-07 /pmc/articles/PMC3546953/ /pubmed/23294475 http://dx.doi.org/10.1186/1471-2377-13-2 Text en Copyright ©2013 Bremell et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Bremell, Daniel
Mattsson, Niklas
Edsbagge, Mikael
Blennow, Kaj
Andreasson, Ulf
Wikkelsö, Carsten
Zetterberg, Henrik
Hagberg, Lars
Cerebrospinal fluid CXCL13 in Lyme neuroborreliosis and asymptomatic HIV infection
title Cerebrospinal fluid CXCL13 in Lyme neuroborreliosis and asymptomatic HIV infection
title_full Cerebrospinal fluid CXCL13 in Lyme neuroborreliosis and asymptomatic HIV infection
title_fullStr Cerebrospinal fluid CXCL13 in Lyme neuroborreliosis and asymptomatic HIV infection
title_full_unstemmed Cerebrospinal fluid CXCL13 in Lyme neuroborreliosis and asymptomatic HIV infection
title_short Cerebrospinal fluid CXCL13 in Lyme neuroborreliosis and asymptomatic HIV infection
title_sort cerebrospinal fluid cxcl13 in lyme neuroborreliosis and asymptomatic hiv infection
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546953/
https://www.ncbi.nlm.nih.gov/pubmed/23294475
http://dx.doi.org/10.1186/1471-2377-13-2
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