In a cohort study, cerebrospinal fluid levels of CXCL13 were markedly elevated in those with a diagnosis of Lyme neuroborreliosis but were less predictive in those without an established diagnosis. The diagnosis of Lyme neuroborreliosis (LNB) can be difficult. The most-used test depends on intrathecal production of Bor-relia burgdorferi-specific antibodies (ItAb) in the cerebrospinal fluid (CSF). This test has limitations, including both low sensitivity early in disease and antibody persistence after appropriate antibiotic therapy. Measurement of CSF CXCL13, a chemo-attractant of B lymphocytes, appears before ItAb and rapidly diminishes with therapy. However, it may be elevated in other neurologic diseases that present with CSF pleo-cytosis. To assess the potential role of CSF CXCL13 in diagnosing LNB, researchers compared CSF CXCL13 levels to ItAb and other markers in CSF samples obtained from patients with various neuroinflam-matory illnesses.
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