Objective To investigate the correlations between B lymphocyte chemoattractant-1 (BLC-1/ CXCL13) level in serum and cerebrospinal fluid (CSF) and disease progress, extended disability status scale (EDSS) score and MR1 scanning in patients with clinical isolated syndrome (CIS), relapsing-remitting multiple sclerosis (RRMS), and neuromyelitis optica (NMO). Methods 18 cases of CIS, 22 cases of RRMS, 21 cases of NMO, and 17 cases of neurological non-inflammatory disease (NND) (as a control group) were collected. The CXCL13 level in serum and CSF was detected by ELISA test method, and compared among the four group patients. All the four group patients performed EDSS score and MRI examination. The CXCL13 level in the serum and CSF was compared between EDSS≥3. 5 points group and EDSS<3. 5 points group and analysed the correlation between the CXCL13 level and EDSS score, and also between the groups with positive and negative MRI enhancement in brain and spinal cord. 18 CIS cases were separated into 2 groups, the CSF CXCL13>10 pg/ mL group and the CSF CXCL13 level<10 pg/mL group, and were followed for two years, comparing the number of CIS patients conversion to MS in these two groups. Results Compared with NND group, the CXCL13 level in serum and CSF was higher in CIS group, RRMS group, and NMO group (P<0. 01). The CXCL13 level in CSF of RRMS group was higher than that in CIS group and NMO group (P<0. 01). The CXCL13 level in the serum and CSF was higher in the EDSS≥3. 5 points group compared with the EDSS<3. 5 points group (P<0. 01).rnAmong these four groups, there were positive correlation between the level of CXCL13 in serum and CSF and EDSS score (r = 0.881, P<0.01; r = 0.753. P<0.01). In addition, 48 patients took the enhanced MR1 scanning of brain and spinal cord, and the CXCL13 level in CSF of enhanced lesion patients was higher than those with no enhanced lesions (P<0. 01). There is higher conversion rate (conversion to MS) in the CSF CXCL13 level>15 pg/mL patients than in the CXCL13 level<10 pg/mL patients (P>0.05). Conclusions The CIS patients with high level of CXCL13 in CSF may earlier convert to MS, and CXCL13 may be a marker predicting MS conversion.%目的 探讨临床孤立综合征(CIS)、复发缓解型多发性硬化(RRMS)、视神经脊髓炎(NMO)患者血清和脑脊液内B淋巴细胞趋化因子-1(BLC-1/CXCL13)的水平与疾病进展、扩展残障状态量表(EDSS)评分及MRI表现的关系.方法 选择CIS患者18例、RRMS患者22例、NMO患者21例,以及神经系统非炎性疾病(neurological non inflammatory disease,NND)患者(作为对照组)17例,采用酶联免疫吸附试验法检测4组患者血清和脑脊液CXCL13水平并进行比较；对4组患者进行发病期EDSS评分及MRI检查,比较EDSS评分≥3.5分和EDSS评分＜3.5分患者血清和脑脊液CXCL13水平,分析CXCL13水平与EDSS评分的相关性,比较头颅和脊髓增强扫描阳性与阴性患者血清及脑脊液CXCL13水平；随访18例CIS患者2年,比较脑脊液CXCL13水平＞10 pg/mL患者与腩脊液CXCL13水平＜10 pg/mL的患者转化为MS的病例数.结果 CIS组、RRMS组及NMO组与NND组患者相比,血清和脑脊液中CXCL13的水平高(均P＜0.01),其中RRMS组患者脑脊液中CXCL13的水平较CIS组和NMO组高(均P＜0.01)；EDSS评分≥3.5分患者血清和脑脊液CXCLI3水平比EDSS评分＜3.5分患者高(均P＜0.01),4组患者血清和脑脊液中CXCL13水平与患者EDSS评分值呈正相关(r=0.881,P＜0.01 ;r=0.753,P＜0.01)；行头颅和脊髓MRI增强扫描的48例患者中,有增强病灶者脑脊液中CXCL13水平比无增强病灶者高(P＜0.01)；脑脊液CXCL13水平＞15 pg/mL的患者转化为MS的比例(37.5％)与脑脊液CXCL13水平＜10 pg/mL的患者(10.0％)比较无统计学差异(P＞0.05).结论 脑脊液CXCL13水平高的CIS患者可能较早地转化为MS,CXCL 13可能是预测CIS转化的标记物.
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