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IL-17 production by CSF lymphocytes as a biomarker for cerebral vasculitis

: Thom, V.; Schmid, S.; Gelderblom, M.; Hackbusch, R.; Kolster, M.; Schuster, S.; Thomalla, G.; Keminer, O.; Pleß, O.; Bernreuther, C.; Glatzel, M.; Wegscheider, K.; Gerloff, C.; Magnus, T.; Tolosa, E.

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Neurology : Neuroimmunology & Neuroinflammation 3 (2016), No.2, 8 pp.
ISSN: 2332-7812
Journal Article, Electronic Publication
Fraunhofer IME ()

Objective: To explore the possibility of using interleukin-17 (IL-17) production by CD41 T cells in the CSF as a potential biomarker for cerebral vasculitis in stroke patients. Methods: In this consecutive case study, we performed prospective analysis of CSF and blood in patients admitted to a university medical center with symptoms of stroke and suspected cerebral vasculitis. Flow cytometry was performed for intracellular detection of inflammatory cytokines in peripheral blood lymphocytes and expanded T cells from CSF. Results: CSF CD4+ lymphocytes from patients with cerebral vasculitis showed significantly higher levels of the proinflammatory cytokine IL-17 compared to patients with stroke not due to vasculitis or with other, noninflammatory neurologic diseases. There was no difference in the production of interferon-y in the CSF and no overall differences in the relative frequencies of peripheral immune cells. Conclusions: Intracellular IL-17 in CSF cells is potentia lly useful in discriminating cerebral vasculitis as a rare cause in patients presenting with ischemic stroke. Classification of evidence: This study provides Class II evidence that an increased proportion of IL-17-producing CD4+ cells in CSF of patients presenting with stroke symptoms is indicative of cerebral vasculitis (sensitivity 73%, 95% confidence interval [CI] 39–94%; specificity 100%, 95% CI 74%–100%).