血清和脑脊液B细胞趋化因子-1的水平对临床孤立综合征转归的意义

目的探讨临床孤立综合征(CIS)患者血清及脑脊液中B细胞趋化因子-1(BLC-1/CX-CL13)浓度与病情变化的关系,与临床表现、磁共振成像(MRI)检查、诱发电位的相关性。方法入选CIS患者73例,包括脊髓型CIS患者20例,脑干型CIS患者18例和视神经型CIS患者19例,神经系统非炎性疾病(NND)16例。在患者发病期进行扩展残障状态量表(EDSS)评分、MRI检查、诱发电位检查,用酶联免疫吸附法(ELISA)检测患者血清及脑脊液中CXCL13浓度。结果脊髓型CIS组、视神经型CIS组、脑干型CIS组血清及脑脊液CXCL13浓度与NND患者比较,差异有统计学意义(P<0.01);脑干型CIS组脑脊液CXCL13浓度高于脊髓和视神经型CIS组,差异有统计学意义(P<0.01);诱发电位异常组与正常组血清和脑脊液CXCL13浓度差异无统计学意义。血清与脑脊液CXCL13浓度呈正相关(r=0.750,P<0.01),血清及脑脊液CXCL13浓度与EDSS评分呈正相关(r=0.837,P<0.01;r=0.689,P<0.01)。结论 CXCL13浓度增高可导致CIS转化为多发性硬化(MS),对预测CIS的转归具有重要的临床意义。

CXCL13 in serum and cerebrospinal fluid for predicting prognosis of clinical isolated syndrome

Objective To determine the correlations between B lymphocyte chemoattractant-1 （BLC-1/CXCL13） concentration in serum and cerebrospinal fluid （CSF） and variation in the disease conditions, clinical manifestations, magnetic resonance imaging and evoked potential in patients with clinical isolated syndrome （CIS）. Methods Of the 73 cases with CIS enrolled in the study, 20 were spinal CIS, 18 were classified as brainstem CIS, 19 belonged to optic nerve CIS, and 16 were diagnosed as having neurological non-inflammatory disease （NND）. Extended disability status scale （EDSS）, magnetic resonance imaging, evoked potential examination, and enzyme-linked immunosorbent assay （ELISA） for serum and cerebrospinal fluid CXCL13 concentration were performed during the development phase of disease. Results There was a marked difference in serum and CSF CXCL13 concentration in spinal CIS, brainstem CIS and optic CIS group as compared with that in NND group （P〈0.01）. Brainstem CIS group exhibited higher CX- CL13 concentration in CSF than spinal and optic CIS group, respectively （P〈0.01）. By contrast, serum and CSF CX- CL13 concentrations did not differ considerably between aberrant and normal evoked potential group. Furthermore, there was a positive correlation between serum and CSF CXCL13 concentrations （r=0.750, P〈0.01）, which were positively correlated with EDSS score （r=0.837, P〈0.01; r= 0.689, P〈0.01, respectively）. Conclusion Elevated CXCL13 concentration may lead to the conversion of CIS into multiple sclerosis, which is of clinical significance for predicting the prognosis of CIS.