Cerebrospinal Fluid Cytokine and Chemokine Profiles in Central Nervous System Sarcoidosis: Diagnostic and Immunopathologic Insights.

Autor: Mangioris G; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA., Pittock SJ; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.; Department of Neurology, Mayo Clinic, Rochester, MN, USA.; Department of Neurology, Mayo Clinic, Jacksonville, FL, USA., Yang B; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA., Fryer JP; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA., Harmsen WS; Department of Neurology, Mayo Clinic, Jacksonville, FL, USA., Dubey D; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.; Department of Neurology, Mayo Clinic, Rochester, MN, USA.; Department of Neurology, Mayo Clinic, Jacksonville, FL, USA., Flanagan EP; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.; Department of Neurology, Mayo Clinic, Rochester, MN, USA.; Department of Neurology, Mayo Clinic, Jacksonville, FL, USA., Lopez-Chiriboga SA; Center for Multiple Sclerosis and Autoimmune Neurology, Mayo Clinic, Rochester, MN, USA., McKeon A; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.; Department of Neurology, Mayo Clinic, Rochester, MN, USA.; Department of Neurology, Mayo Clinic, Jacksonville, FL, USA., Mills JR; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA., Vodopivec I; Roche Product Development-Neuroscience, F. Hoffmann-La Roche, Basel, Switzerland., Tobin WO; Department of Neurology, Mayo Clinic, Rochester, MN, USA.; Department of Neurology, Mayo Clinic, Jacksonville, FL, USA., Toledano M; Department of Neurology, Mayo Clinic, Rochester, MN, USA.; Department of Neurology, Mayo Clinic, Jacksonville, FL, USA., Aksamit AJ; Department of Neurology, Mayo Clinic, Rochester, MN, USA., Zekeridou A; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.; Department of Neurology, Mayo Clinic, Rochester, MN, USA.; Department of Neurology, Mayo Clinic, Jacksonville, FL, USA.
Jazyk: angličtina
Zdroj: Annals of neurology [Ann Neurol] 2024 Jul 19. Date of Electronic Publication: 2024 Jul 19.
DOI: 10.1002/ana.27024
Abstrakt: Objective: To evaluate the cerebrospinal fluid (CSF) cytokine/chemokine profile of central nervous system (CNS) neurosarcoidosis (NS), and its utility in differential diagnosis, treatment, and prognostication.
Methods: In this case-control study, we validated 17 cytokines/chemokines (interleukin [IL]-1-beta, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12p70, IL-13, IL-17A, BAFF, IL-8/CXCL8, CXCL9, CXCL10, CXCL13, GM-CSF, interferon-gamma, and tumor necrosis factor [TNF]-alpha) in a multiplexed automated immunoassay system (ELLA; Bio-Techne, Minneapolis, MN, USA), and assessed them in CSF and serum of symptomatic patients with probable or definite CNS NS (01/2011-02/2023) with gadolinium enhancement and/or CSF pleocytosis. Patients with multiple sclerosis, primary CNS lymphoma, aquaporin-4 immunoglobulin G positivity, non-inflammatory disorders, and healthy individuals were used as controls.
Results: A total of 32 NS patients (59% women; median age, 59 years [19-81]) were included; concurrent sera were available in 12. CSF controls consisted of 26 multiple sclerosis, 8 primary CNS lymphoma, 84 aquaporin-4 immunoglobulin G positive, and 34 patients with non-inflammatory disorders. Gadolinium enhancement was present in 31 of 32 NS patients, and CSF pleocytosis in 27 of 32 (84%). CSF IL-2, IL-6, IL-10, IL-13, BAFF, IL-8/CXCL8, CXCL9, CXCL10, CXCL13, GM-CSF, interferon-gamma, and TNF-alpha levels were significantly higher in NS patients compared with non-inflammatory controls (p ≤ 0.02); elevations were more common in CSF than serum. Concurrent elevation of IL-6, CXCL9, CXCL10, GM-CSF, interferon-gamma, and TNF-alpha was present in 18 of 32 NS patients, but only in 1 control. Elevated IL-6, IL-10, IL-13, CXCL9, CXL10, GM-CSF, and TNF-alpha associated with measures of disease activity.
Interpretation: NS CSF cytokine/chemokine profiles suggest T cell (mainly T helper cell type 1), macrophage, and B-cell involvement. These signatures aid in NS diagnosis, indicate disease activity, and suggest therapeutic avenues. ANN NEUROL 2024.
(© 2024 American Neurological Association.)
Databáze: MEDLINE
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