biomarker for cerebral vasculitis

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 CD41 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-g in the CSF and no overall differences in the relative frequencies of peripheral immune cells. Conclusions: Intracellular IL-17 in CSF cells is potentially 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 IL17-producing CD41 cells in CSF of patients presenting with stroke symptoms is indicative of cerebral vasculitis (sensitivity 73%, 95% confidence interval [CI] 39–94%; specificity 100%,

[1]  Daniela Latorre,et al.  Functional heterogeneity of human memory CD4+ T cell clones primed by pathogens or vaccines , 2015, Science.

[2]  Yevhen Vainshtein,et al.  Individual T helper cells have a quantitative cytokine memory. , 2015, Immunity.

[3]  P. Berlit,et al.  Cerebral vasculitis in adults: what are the steps in order to establish the diagnosis? Red flags and pitfalls , 2014, Clinical and experimental immunology.

[4]  L. Calabrese,et al.  Diagnosis and classification of central nervous system vasculitis. , 2014, Journal of autoimmunity.

[5]  C. Weyand,et al.  Immune mechanisms in medium and large-vessel vasculitis , 2013, Nature Reviews Rheumatology.

[6]  G. Hunder,et al.  Adult primary central nervous system vasculitis , 2012, The Lancet.

[7]  P. Tak,et al.  Effects of AIN457, a Fully Human Antibody to Interleukin-17A, on Psoriasis, Rheumatoid Arthritis, and Uveitis , 2010, Science Translational Medicine.

[8]  C. Kallenberg.  Pathophysiology of ANCA-Associated Small Vessel Vasculitis , 2010, Current rheumatology reports.

[9]  A. Salama,et al.  Serum IL-17 and IL-23 levels and autoantigen-specific Th17 cells are elevated in patients with ANCA-associated vasculitis. , 2010, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[10]  E. Tolosa,et al.  Phenotypical and functional characterization of T helper 17 cells in multiple sclerosis. , 2009, Brain : a journal of neurology.

[11]  C. Kallenberg,et al.  Skewed distribution of Th17 lymphocytes in patients with Wegener's granulomatosis in remission. , 2008, Arthritis and rheumatism.

[12]  B. Yard,et al.  Persistent T-cell activation and clinical correlations in patients with ANCA-associated systemic vasculitis. , 2006, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.