Cerebrospinal fluid levels of BAFF and APRIL in untreated multiple sclerosis

Objective and subjects: To examine in vivo levels of BAFF (B-cell activating factor of the tumor necrosis factor family) and APRIL (a proliferation-inducing ligand) in both the cerebrospinal fluid (CSF) and serum of 30 naïve MS patients and 79 subjects affected by acute or chronic inflammatory or non-inflammatory neurological diseases. Design: Case-control study. Results: No difference among groups was evidenced in serum BAFF or APRIL levels. By contrast, CSF levels of BAFF in MS (mean 144.3 pg/ml ± 141.2), although not significantly different from those observed in NIND (164.2 pg/ml ± 92.0), acute peripheral OIND (243.1 pg/ml ± 139.0) or chronic OIND (240.2 pg/ml ± 122.5), were significantly higher in acute central OIND patients (1274.0 pg/ml ± 803.8; p < 0.001 vs. all groups). Similarly, CSF APRIL levels in MS (1541.0 pg/ml ± 1071.0), NIND (2629.0 pg/ml ± 1669.0), acute peripheral OIND (2834.0 pg/ml ± 1118.) or chronic OIND (2764.0 pg/ml ± 659.7) were not significantly different, while they were significantly higher in acute central OIND (6218.0 pg/ml ± 3790.0; p < 0.001 vs. MS and NIND; and p < 0.05 vs. acute peripheral OIND). Conclusions: Our results strongly suggest that further investigation is warranted to elucidate the role of BAFF and APRIL in MS and that serum levels of BAFF and APRIL do not reflect CSF levels.