Cytokines and
chemokines contribute to the pathogenesis of
acute disseminated encephalomyelitis (ADEM). Using a multiplex immunochemiluminescence ELISA, we measured 8 Th1/Th2
cytokines and 18
chemokines in the cerebrospinal fluid (CSF) and serum of 17 ADEM patients, 14
multiple sclerosis (MS) patients, and 7 healthy controls (HCs). Relative to HCs, ADEM patients had significantly high mean CSF concentrations of
chemokines with attractant/activating properties towards neutrophils (CXCL1 and CXCL7), monocytes/T cells (CCL3 and CCL5), Th1 cells (CXCL10), and Th2 cells (CCL1, CCL22, and CCL17). Mean CSF concentrations of CXCL7, CCL1, CCL22, and CCL17 were higher in ADEM than in MS, whereas those of CCL11 were lower in MS than in ADEM and HCs. CSF
pleocytosis correlated with CSF concentrations of CXCL1, CXCL10, CCL1, CCL17, and CCL22. Most of the functionally homologous
chemokines correlated with each other. CSF Th1/Th2
cytokines were not detectable in most samples. Their mean concentrations did not differ in the three groups, and the same held for serum
cytokines and
chemokines. Our data suggest that the upregulation of
chemokines active on neutrophils and Th2 cells differentiates ADEM from MS
inflammation, and that both Th1 and Th2
chemokines might be produced in ADEM.
Chemokines upregulated in ADEM could become CSF
biomarkers after a posteriori evaluations in unselected case series.