Rapid dia­gnostics of chemokine CXCL13 in the cerebrospinal fluid of patients with neuroborreliosis

Authors: D. Pícha ;  L. Moravcová ;  D. Smíšková
Authors‘ workplace: Klinika infekčních nemocí 2. LF UK a Nemocnice Na Bulovce, Praha
Published in: Cesk Slov Neurol N 2019; 82(2): 0
Category: Short Communication
doi: 10.14735/amcsnn2019215


Chemokine CXCL13 is a strong chemoattractant for leukocytes in the CSF. It has been proven that CSF CXCL13 concentration is substantially elevated in the early stage of Lyme neuroborreliosis (LNB). Its level is increased even before the specific antibodies are synthesized in this compartment. CXCL13 was proven to have high positive and negative diagnostic significance and this diagnostic attitude has not yet been included in a routine clinical diagnostic algorithm of LNB. Two methods of chemokineCXCL13 detection in CSF were tested in two groups of patients with clinical manifestations of LNB and other aseptic neuroinfections: 1. semiquantitative immunochromatic method ReaScan CXCL13 rapid test and 2. quantitative method CXCL13/ BLC/ BCA-1 Quantikine ELISA. A high concordance of the results of these tests was verified using Cohen coefficient kappa (P < 0.001). The ReaScan CXCL13 rapid test is easy to use and time-saving (20 min), therefore, it is suitable as an additional examination for routine early diagnostics of LNB. Proving CSF CXCL13 elevation enables quick antibiotic treatment, especially in cases where the local antibody synthesis has not been proven yet, which can be seen in the proposed diagnostic algorithm.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.


Lyme neuroborreliosis – CXCL13 chemokine – diagnostics


1. Koedel U, Fingerle V, Pfister HW. Lyme neuroborreliosis-epidemiology, dia­gnosis and management. Nat Rev Neurol 2015; 11(8): 446–456. doi: 10.1038/ nrneurol.2015.121.
2. Hammers-Berggren S, Hansen K, Lebech AM et al. Borrelia burgdorferi-specific intrathecal antibody production in neuroborreliosis: a folow-up study. Neurology 1993; 43(1): 169–175.
3. Mygland A, Ljøstad U, Fingerle V et al. EFNS guidelines on the dia­gnosis and management of European Lyme neuroborreliosis. Eur J Neurol 2010; 17(1): 8–16. doi: 10.1111/ j.1468-1331.2009.02862.x.
4. De Haas AH, van Weering HR, de Jong EK et al. Neuronal chemokines: versatile messengers in central nervous system cell interaction. Mol Neurobio­l 2007; 36(2): 137-151. doi: 10.1007/ s12035-007-0036-8.
5. Ljøstad U, Mygland A. CSF B – lymphocyte chemoattractant (CXCL13) in the early dia­gnosis of acute Lyme neuroborreliosis. J Neurol 2008; 255(5): 732–737. doi: 10.1007/ s00415-008-0785-y.
6. Rupprecht TA, Pfister HW, Angele B et al. The chemokine CXCL13 (BLC): a putative dia­gnostic marker for neuroborreliosis. Neurology 2005; 65(3); 448–450. doi: 10.1212/ 01.wnl.0000171349.06645.79.
7. Hytönen J, Kortela E, Waris M et al. CXCL13 and neo­pterin concentrations in cerebrospinal fluid of patients with Lyme neuroborreliosis and other diseases that cause neuroinflammantion. J Neuroinflammation 2014; 11: 103. doi: 10. 1186/ 1742-2094-11-103.
8. Pícha D, Moravcová L, Smíšková D. Prospective study on the chemokine CXCL13 in neuroborreliosis and other aseptic neuroinfections. J Neurol Sci 2016; 368: 214–220. doi: 10.1016/ j.jns.2016.05.059. 
9. Rubenstein JL, Wong VS, Kadoch C et al. CXCL13 plus interleukin 10 is highly specific for diagnosis of CNSLymphoma. Blood 2013; 121(23): 4740–4748. doi: 10.1182/ blood-2013-01-476333.
10. van Burgel ND, Bakels F, Kroes AC et al. Discriminating Lyme neuroborreliosis from other neuroinflammatory diseases by levels of CXCL13 in cerebrospinal fluid. J Clin Microbio­l 2011; 49(5): 2027–2030. doi: 10.1128/ JCM.00084-11.
11. Schmidt C, Plate A, Angele B et al. A prospective study on the role of CXCL13 in Lyme neuroborreliosis. Neurology 2011; 76(12): 1051–1058. doi: 10.1212/ WNL.0b013e318211c39a.
12. Koedel U, Pfister HW. Lyme neuroborreliosis. Curr Opin Infect Dis 2017; 30(1): 101–107. doi: 10.1097/ QCO.0000000000000332.
13. Rupprecht TA, Manz KM, Fingerle V et al. Dia­gnostic value of cerebrospinal fluid CXCL13 for acute Lyme neuroborreliosis. A systematic review and meta-analy­sis. Clin Microbio­l Infect 2018; 24(12): 1234–1240. doi: 10.1016/ j.cmi.2018.04.007.

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