A marker for active MS points at B cells

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Intrathecally produced CXCL13: A predictive biomarker in multiple sclerosis.DiSano KD, Gilli F, Pachner AR.Mult Scler J Exp Transl Clin. 2020 Dec 16;6(4):2055217320981396. 

Background: Clinicians caring for patients with Multiple Sclerosis (MS) need improved biomarkers to aid them in disease management.

Objective: We assessed the predictive value of the candidate biomarker CXCL13 index in comparison to oligoclonal bands (OCBs) and CSF neurofilament light (NfL) concentration, examining the ability of each biomarker to predict future disease activity in clinically and radiologically isolated syndromes, relapsing-remitting MS, and progressive MS.

Methods: Matched serum and CSF samples were obtained from 67 non-inflammatory neurologic disease patients and 67 MS patients. CSF and serum CXCL13 and CSF NfL were analyzed by Luminex and ELISA, respectively. CXCL13 data were also analyzed as CSF/serum ratios and indices. Electronic medical records were accessed to determine diagnosis, CSF profiles, and disease activity after the lumbar puncture.

Results: Among CXCL13 measures, CXCL13 index was the best predictor of future disease activity in MS patients (AUC = 0.82; CI = 0.69-0.95; p = 0.0002). CXCL13 index values were significantly elevated in activity-positive MS patients compared to activity-negative patients (p < 0.0001). As a single predictor, CXCL13 index outperformed both OCBs and CSF NfL in sensitivity, specificity, and positive and negative predictive value, for future disease activity in MS patients. Moreover, combining CXCL13 index and CSF NfL status improved sensitivity and predictive values for disease activity in MS patients.

Conclusions: The CXCL13 index is an excellent candidate prognostic biomarker for disease activity in patients with MS.

So they suggest that CXL13 is higher in active MS and so may predict activity. If I look at non active MS there is overlap and this makes it less useful , but I will let NDG comment on the suitability, but CXCL13 is a protein that attracts cells and the cells that it is attracts are B cells. Chemokine (C-X-C motif) ligand 13 (CXCL13), also known as B lymphocyte chemoattractant (BLC) or B cell-attracting chemokine 1 (BCA-1). In T lymphocytes, CXCL13 expression is thought to reflect a germinal center origin of the T cell, particularly a subset of T cells called follicular B helper T cells (or TFH cells).

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