Thom, V.V.ThomSchmid, S.S.SchmidGelderblom, M.M.GelderblomHackbusch, R.R.HackbuschKolster, M.M.KolsterSchuster, S.S.SchusterThomalla, G.G.ThomallaKeminer, O.O.KeminerPleß, O.O.PleßBernreuther, C.C.BernreutherGlatzel, M.M.GlatzelWegscheider, K.K.WegscheiderGerloff, C.C.GerloffMagnus, T.T.MagnusTolosa, E.E.Tolosa2022-03-052022-03-052016https://publica.fraunhofer.de/handle/publica/25726210.1212/NXI.00000000000002142-s2.0-85033342640Objective: 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%).en540571572journal article