Abstract

Purpose

Multiple sclerosis (MS) is the most common immune-mediated CNS disease, characterised by demyelination and progressive neurological disability. The B-cell activating factor BAFF has been described as one important factor in the pathophysiology of different autoimmune diseases.

Methods

We measured BAFF levels in the serum and cerebrospinal fluid (CSF) in 50 consecutive patients with MS and 35 patients with infectious CNS disease (ID). 52 patients with other, non-inflammatory disorders (OND), served as controls.

Results

BAFF-serum levels in ID patients were higher than in patients diagnosed with MS (ID 0.55 ± 0.24 ng/ml, MS 0.43 ± 0.14 ng/ml, OND 0.45 ± 0.24 ng/ml; p = 0.09). Interestingly, MS patients had lower BAFF CSF levels compared to the controls and ID patients, and the CSF levels in the latter were elevated compared to those of the controls (MS 0.17 ± 0.11 ng/ml, OND 0.25 ± 0.14 ng/ml, ID 0.97 ± 0.78 ng/ml; p < 0.001).

Conclusions

The ID patients’ having higher absolute BAFF levels in the CSF than in the serum indicates that the increased BAFF CSF levels were caused by intrathecal synthesis rather than passive transfer via a disturbed blood-brain-barrier. The significantly decreased BAFF CSF levels in MS patients were a surprising result of our study. Although it has been reported that astrocytes in active MS lesions can express BAFF, the soluble form was not increased in the CSF of MS patients. It remains unclear whether the inflammatory features of active MS plaques are truly represented by the CSF compartment.

中文翻译：

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多发性硬化症和感染性神经系统疾病患者的 BAFF 血清和 CSF 水平

摘要

目的

多发性硬化症 (MS) 是最常见的免疫介导的中枢神经系统疾病，其特征是脱髓鞘和进行性神经功能障碍。B 细胞激活因子 BAFF 已被描述为不同自身免疫性疾病的病理生理学中的一个重要因素。

方法

我们测量了 50 名连续 MS 患者和 35 名感染性中枢神经系统疾病 (ID) 患者的血清和脑脊液 (CSF) 中的 BAFF 水平。52 名患有其他非炎症性疾病 (OND) 的患者作为对照。

结果

ID 患者的 BAFF 血清水平高于诊断为 MS 的患者（ID 0.55 ± 0.24 ng/ml，MS 0.43 ± 0.14 ng/ml，OND 0.45 ± 0.24 ng/ml；p  = 0.09）。有趣的是，与对照组和 ID 患者相比，MS 患者的 BAFF CSF 水平较低，而后者的 CSF 水平与对照组相比升高（MS 0.17 ± 0.11 ng/ml，OND 0.25 ± 0.14 ng/ml，ID 0.97 ± 0.78 ng/ml；p  < 0.001)。

结论

ID 患者 CSF 中的绝对 BAFF 水平高于血清中的绝对值表明 BAFF CSF 水平的增加是由鞘内合成引起的，而不是通过受干扰的血脑屏障的被动转移。MS 患者的 BAFF CSF 水平显着降低是我们研究的一个令人惊讶的结果。尽管据报道，活动性 MS 病变中的星形胶质细胞可以表达 BAFF，但 MS 患者的 CSF 中的可溶性形式并未增加。目前尚不清楚活动性 MS 斑块的炎症特征是否真正由 CSF 隔室代表。