title: Cerebrospinal fluid chemokine CXCL13 in the diagnosis of neuroborreliosis in children.
abstract: BACKGROUND
  The diagnosis of Lyme neuroborreliosis (LNB) requires laboratory confirmation because neurological symptoms indicative of LNB are not specific. Recent studies have suggested that a chemokine, CXCL13, could have an important role in the diagnosis of LNB. The aim of this study was to assess CXCL13 levels in the cerebrospinal fluid (CSF) of children with LNB.
  
  
  METHODS
  CSF samples were available for 57 children with symptoms indicative of LNB. Based on the presence of anti-flagella antibodies and pleocytosis in CSF, patients were divided into 3 different groups: confirmed LNB (n = 24), possible LNB (n = 16), and non-LNB (n = 17). CXCL13 levels were determined with a commercial kit (Quantikine).
  
  
  RESULTS
  All 24 patients with confirmed LNB had elevated CXCL13 levels in CSF. Elevated CXCL13 was also observed in the majority of patients without anti-flagella antibodies in the CSF (possible LNB). Of the 17 non-LNB and 50 control samples, 1 was positive.
  
  
  CONCLUSIONS
  In LNB, the production of CXCL13 in CSF seems to precede antibody production. Assessment of CSF CXCL13 may improve the diagnostics for children with possible LNB.
authors.affiliation: Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, Helsinki, Finland.
authors.forename: Heidi
authors.initials: H
authors.lastname: Sillanpää
authors.forename: Barbro H
authors.initials: BH
authors.lastname: Skogman
authors.forename: Heikki
authors.initials: H
authors.lastname: Sarvas
authors.forename: Ilkka J T
authors.initials: IJ
authors.lastname: Seppälä
authors.forename: Pekka
authors.initials: P
authors.lastname: Lahdenne
mesh_terms: D000293:Adolescent; D000907:Antibodies, Bacterial / Q000134:cerebrospinal fluid; D015415:Biomarkers / Q000134:cerebrospinal fluid*; D054382:Chemokine CXCL13 / Q000134:cerebrospinal fluid*; D002648:Child; D002675:Child, Preschool; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods; D020852:Lyme Neuroborreliosis / Q000175:diagnosis*; D008297:Male
chemical_list: D000907:Antibodies, Bacterial; D015415:Biomarkers; C110663:CXCL13 protein, human; D054382:Chemokine CXCL13