Department of Neurology, Faculty of Medicine, Justus-Liebig-University, Giessen, Germany.
Heart & Brain Research Group, Justus-Liebig-University Giessen and Kerckhoff Clinic, Bad Nauheim, Germany.
Int J Neurosci. 2021 Dec;131(12):1231-1236. doi: 10.1080/00207454.2020.1784167. Epub 2020 Jun 30.
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.
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.
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; = 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; < 0.001).
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 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.
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病理生理学中的一个重要因素。
我们测量了 50 例连续 MS 患者和 35 例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 例其他非炎症性疾病（OND）患者作为对照。
ID 患者的 BAFF 血清水平高于 MS 患者（ID 0.55±0.24ng/ml，MS 0.43±0.14ng/ml，OND 0.45±0.24ng/ml； = 0.09）。有趣的是，MS 患者的 CSF 中 BAFF 水平低于对照组和 ID 患者，而后者的 CSF 水平高于对照组（MS 0.17±0.11ng/ml，OND 0.25±0.14ng/ml，ID 0.97±0.78ng/ml； < 0.001）。
ID 患者 CSF 中的绝对 BAFF 水平高于血清，表明增加的 CSF 中的 BAFF 水平是由于鞘内合成而不是被动转移引起的，即血脑屏障受到干扰。MS 患者的 CSF 中 BAFF 水平显著降低是我们研究的一个意外结果。尽管据报道，活跃 MS 病变中的星形胶质细胞可以表达 BAFF，但可溶性形式并未增加 MS 患者的 CSF 中。目前尚不清楚活跃 MS 斑块的炎症特征是否真正代表了 CSF 区室。
