Pozzilli, Valeria;
Thambiliyagodage, Manori Prasadani;
Mankad, Kshitij;
Worth, Austen;
Brogan, Paul;
Ghorashian, Sara;
Bamford, Alasdair;
... Hacohen, Yael; + view all
(2025)
CSF IL-6 in children with neuroinflammatory conditions.
European Journal of Paediatric Neurology
, 58
pp. 42-49.
10.1016/j.ejpn.2025.07.013.
![[thumbnail of Manuscript_full_merged.pdf]](https://discovery.ucl.ac.uk/style/images/fileicons/text.png) |
Text
Manuscript_full_merged.pdf - Accepted Version Access restricted to UCL open access staff until 3 August 2026. Download (11MB) |
Abstract
Introduction: Cerebrospinal fluid (CSF) cytokines may contribute to immune-mediated processes affecting the central nervous system (CNS). We evaluated CSF cytokine profiles in children with suspected neuroinflammatory conditions to explore their clinical relevance. // Methods: Between 2019 and 2024, CSF from children <18 years were analyzed using BD Biosciences cytokine bead array for interleukin-2 (IL-2), IL-4, IL-6, IL-10, interferon-alpha (IFN-α), and tumour necrosis-factor-alpha (TNF-α). Clinical phenotyping was conducted. Serum cytokine levels were measured in cases with abnormal CSF, when available. // Results: 112 patients were included (median age 6 years [IQR 3.6–11.2]; 54 % male). CSF IL-6 was raised in 35/112 (31 %; median 107 pg/ml, IQR 24–329). No other cytokine was raised without concurrent IL-6. Raised CSF IL-6 occurred in 16/50 acquired neuroimmune conditions (including myelin oligodendrocyte glycoprotein antibody-associated disease, seronegative demyelination, seronegative autoimmune encephalitis, and febrile-infection-related epilepsy syndrome), 5/9 CNS infections; 9/17 monogenic autoinflammatory syndromes, and 5/7 cancer treatment-related neurotoxicities. Of the 35 patients with raised CSF IL-6, 21 had serum cytokines tested; 13 (62 %) showed elevated serum IL-6. In demyelinating cases, higher IL-6 was associated with increased CSF protein (p = 0.007). Follow-up CSF samples (n = 16, median 34 days) showed persistent elevation in 7 and normalisation in 9. IL-6 inhibitors (tocilizumab and/or siltuximab) were used in 10 patients with variable outcomes, depending on the underlying etiology. // Conclusions: CSF IL-6 was the most frequently elevated cytokine in our cohort, observed across a range of primary and secondary neuroinflammatory disorders. While not diagnostic of a specific condition, its elevation may help guide treatment decisions.
Archive Staff Only
 |
View Item |
