The Relationship Between CXCL13in Cerebrospinal Fluid And Clinically Isolated Syndrome And Multiple Sclerosis: A Meta-analysis

Objective To evaluate the relation between the chemokine CXCL13inCSF and clinical isolated syndrome and multiple sclerosis.Methods We searched Pubmed (1966-2013), Embase (1974-2013), Ovid(1993-2013), The Cochrane Library (Issue4,2013), CBMdisc (1978to2013),CNKI(1979to2013),VIP (1989to2013) and Wan fang Database(1978to2013)by electronic database to collect cohort and case-control studies of therelationship between the chemokine CXCL13and clinically isolated syndromeand multiple sclerosis. The quality of included studies were assessed according tothe criteria recommended by the Cochrane Handbook for Systematic Reviews ofInterventions and data were extracted by two reviewers independently. We mademeta-analysis, quantitative qualitative comprehensive analysis, funnel plotanalysis for the results of studies. In this meta-analysis, fixed or random potencymodel was chosen according to the heterogeneity. Meta analysis was conducted byThe Cochrane Collaboration’s RevMan5.2software. Estimated the evaluationindex by95%confidence interval and made α=0.05for the size of test.Results We incorporate6literatures and got a sample of1011casesincluding721cases （multiple sclerosis and clinically isolated syndrome）in casegroup and290cases （neurological non-inflammatory disease）in control group.The results of Meta-analysis showed that:(1)CSF CXCL13was significantlyelevated in MS group as compared to neurological non-inflammatory disease （NND）group (p<0.00001).(2) Compared to CIS group, CSF CXCL13wassignificantly elevated in MS group(p<0.00001).(3) It was significantly elevated inCIS-MS group as compared to CIS-CIS group(P=0.009) over a follow-up of2years.(4) The conversion rate in>10pg/ml group was higher than in CSF’s CXCL13<10pg/ml group(P=0.0005).Conclusion Compared to NND group and CIS Group, the level of CXCL13in CNS is significantly elevated in MS group, and the rate is normal correlationbetween the level of CXCL13in CNS and the CIS’s conversion, which means thatthe level of CXCL13in CSF is associated with the occurrence and developmentof CIS and MS，and has an important value for prediction the outcome of CIS.Thequantity of included studies in this Meta-analysis were less，and the quality werenot high and the selection bias, information bias and confounding bias can not beavoided which could have influence of the results. We expect larger sample andhigh quality epidemiologic studies to further improve the results of this research.