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The cerebrospinal fluid CD 4/ CD 8 ratio and interleukin‐6 and ‐10 levels in neurosarcoidosis: a multicenter, pragmatic, comparative study
Author(s) -
Chazal T.,
Costopoulos M.,
Maillart E.,
Fleury C.,
Psimaras D.,
Legendre P.,
Pineton de Chambrun M.,
Haroche J.,
Lubetzki C.,
Amoura Z.,
LegarffTavernier M.,
Cohen Aubart F.
Publication year - 2019
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13975
Subject(s) - neurosarcoidosis , medicine , cerebrospinal fluid , sarcoidosis , gastroenterology , multiple sclerosis , hazard ratio , confidence interval , immunology
Background and purpose Neurosarcoidosis is a rare inflammatory disorder of unknown cause. The aim of this study was to evaluate the value of T/B lymphocyte population counts and the concentrations of the cytokines interleukin ( IL ) 6 and IL‐10 in the cerebrospinal fluid ( CSF ) of neurosarcoidosis patients. Methods A retrospective study CSF biomarkers was conducted in patients with neurosarcoidosis who underwent CSF analysis between 2012 and 2017 as well as various control populations. Results Forty‐three patients with neurosarcoidosis, 14 with multiple sclerosis ( MS ) and 48 with other inflammatory disorders were analyzed. The CSF IL ‐6 levels were higher in sarcoidosis patients than in MS patients (median 8 vs. 3 pg/ml, P = 0.006). The CSF CD 4/ CD 8 ratio was higher in sarcoidosis patients than in MS patients and in patients with other inflammatory disorders (median 3.18 vs. 2.36 and 2.10, respectively, P = 0.008). The CSF IL ‐6 level was higher in patients with active neurosarcoidosis than in non‐active neurosarcoidosis patients (median 13 vs. 3 pg/ml, P = 0.0005). In patients with neurosarcoidosis, a CSF IL ‐6 concentration >50 pg/ml was associated with a higher risk of relapse or progression‐free survival (hazard ratio 3.60; 95% confidence interval 1.78–23.14). A refractory neurosarcoidosis patient was treated with an anti‐ IL ‐6 monoclonal antibody that produced a complete neurological response. Conclusions The CSF CD 4/ CD 8 ratio and IL ‐6 concentration are increased in neurosarcoidosis compared to MS and other inflammatory disorders. A CSF IL ‐6 concentration >50 pg/ml is associated with relapse or progression of neurosarcoidosis. IL ‐10 levels may be elevated in neurosarcoidosis.