Neuromyelitis optica (NMO) and Multiple sclerosis (MS) are two typical inflammatory demyelinating diseases of the central nervous system (CNS) with complex pathogenesis, and they share many similarities. Neuromyelitis optica was considered an optic-spinal form of MS until specific antibodies (NMO-IgG) were suggested to be a biomarker of NMO, distinguishing it from conventional MS 1 . T cells have emerged as a key player in the pathogenesis of MS 2 . We also found increased levels of CD4 + T cells in NMO patients 3 . Simultaneously, B cells are believed to play an important role in the pathogenesis of these diseases. A role of B cells in MS pathogenesis has been suggested by the presence of oligoclonal immunoglobulin bands (OCBs) in cerebrospinal fluid (CSF) 4,5 . In addition, NMO-IgG is compelling evidence for B cells involvement in NMO pathogenesis 6 . Moreover, therapies which eliminate antibodies ABSTRACT: Background: Neuromyelitis optica (NMO) and multiple sclerosis (MS) are inflammatory demyelinating diseases of human central nervous system (CNS) with complex pathogenesis. Il-21/Il-21R regulates activation, proliferation and survival of both T cells and B cells, which are involved in the pathogenesis of NMO and MS. High levels of serum Il-21 were observed in NMO patients. However, concentration of cerebrospinal fluid (CSF) Il-21 in MS and NMO patients still remain unknown. Object: To detect the CSF concentration of Il-21 in NMO and MS patients and to evaluate its relationship with disease activity, particularly concerned about its impact on humoral immunity. Methods: CSF Il-21 was detected by an enzyme-linked immunosorbent assay (elISA) in NMO patients (n=21), MS patients (n=20) and controls (n=16). Results: CSF concentration of the Il-21 was noticeably elevated in NMO (p=0.012) and borderline significantly increased in MS (p=0.115). In addition, this occurrence was associated with humoral immune activity as shown by a correlation between Il-21 and complement in NMO cohort (p=0.023) and high Il-21 levels in autoantibodypositive subgroup (p=0.027). Conclusions: The concentration of CSF Il-21 was noticeably elevated and might have a positive correlation with humoral immune activity in NMO.
RÉSUMÉ: Les niveaux d'IL-21 du liquide céphalo-rachidien dans