Evaluation of cerebrospinal fluid CXCL13 concentrations and lymphocyte subsets in tick-borne encephalitis. (April 2020)

• Record Type: Journal Article
• Authors: Toczylowski, Kacper; Grygorczuk, Sambor; Osada, Joanna; Wojtkowska, Malgorzata; Bojkiewicz, Ewa; Wozinska-Klepadlo, Marta; Potocka, Paulina; Sulik, Artur
• Is Part Of: International journal of infectious diseases. Volume 93(2020)
• Page Start: 40
• Page End: 47
• Publication Date: 2020-04
• Subjects: Tick-borne encephalitis -- Meningitis -- CXCL13 -- Flow cytometry; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2020.01.023
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Recent studies have suggested that the clinical presentation of tick-borne encephalitis (TBE) is determined by the host immune responses to the virus. In this study, cerebrospinal fluid (CSF) in TBE was enriched in CD4+ T-cells. TBE meningoencephalitis was associated with higher CSF CXCL13 concentrations. CXCL13 may be involved in the neuropathology of TBE, but it remains unclear whether this chemokine contributes to disease severity. Abstract: Objectives: Recent studies suggest that the clinical presentation of tick-borne encephalitis (TBE) is determined by the host immune responses to the tick-borne encephalitis virus (TBEV). The aim of the study was to characterize immune responses in TBE to give a better insight into the immunopathogenesis of this disease. Methods: Anti-TBEV antibody levels, cerebrospinal fluid (CSF) and blood lymphoid populations, and concentrations of CXCL13 (a potent B-cell and T-cell chemoattractant), were analyzed in 35 patients with TBE (20 adults and 15 children). Results: When compared with the blood, the CSF lymphoid population was significantly enriched in CD4+ T-cells and relatively depleted in natural killer (NK) cells and B lymphocytes. In comparison with TBE meningitis, patients suffering from TBE meningoencephalitis ( n = 11, 31%) had a 3.5-fold higher median CSF CXCL13 concentration, 1.8-fold higher CSF/serum ratio of anti-TBEV IgG antibodies, and 1.8-fold higher median CSF cell count. CSF CXCL13 levels did not change significantly in children with TBE meningitis receiving supportive treatment, but decreased in children with TBE meningoencephalitis who received intravenous steroids. Conclusions: CD4+ cells are abundant in the CSF of patients with TBE. CXCL13 may be involved in the neuropathology of TBE by attracting different subsets of lymphocytes to the CSF.