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Abstract Details

Cerebrospinal Fluid Biomarkers in Neurosarcoidosis: Evaluating the IL-2 and IL-6 Pathways
Autoimmune Neurology
P1 - Poster Session 1 (11:45 AM-12:45 PM)
8-005
To assess levels of cerebrospinal fluid (CSF) cytokines associated with interleukins IL-2 and IL-6 pathways in patients with neurosarcoidosis (NS) and compare them with systemic sarcoidosis without neurological involvement (SS), inflammatory, and non-inflammatory controls (NIC).
Sarcoidosis is a systemic granulomatous disorder that affects the central or peripheral nervous system (CNS or PNS) in 5-25% of patients. Overlapping features with other conditions make diagnosis of NS difficult, highlighting the need for less invasive biomarkers.
We measured CSF levels of IL-2, IL-6 and their receptors, soluble interleukin-2 receptor alpha (sIL-2Rα), and soluble interleukin-6 receptor (sIL-6R) using an immune-based multiplexed bead arrays (Luminex) and an automated immunoassay system (ELLA; Bio-Techne). Patients with probable and definite NS with clinical evidence of active disease (e.g., abnormal MRI and/or CSF findings), SS, multiple sclerosis (MS), cryptococcal meningitis (CM), and NIC were included. Statistical analyses were performed using GraphPad Prism Version 10.3.1, with significance set at p < 0.05.
Forty CSF samples were analyzed: 9 from NS patients, 8 each from SS, MS, NIC, and 7 from CM. Fifty-six percent of NS patients were male and African-American, with a median age of 44 years (IQR 34-58). ELLA showed greater sensitivity than Luminex for sIL-2Rα detection. sIL-2Rα levels were significantly higher in NS compared with SS, MS, and NIC while IL-2 levels were undetectable. NS patients also had significantly higher levels of IL-6 compared to SS and NIC, though sIL-6R levels were elevated only in CM compared to NS.

Elevated CSF IL-6 and sIL-2Rα levels may serve as useful biomarkers to distinguish NS from other conditions, potentially reducing the reliance on invasive diagnostic procedures such as biopsy. Further validation in larger cohorts is necessary to confirm their clinical utility and assess correlations with patient outcomes.
Authors/Disclosures
Susana Dominguez Penuela, MD
PRESENTER 		Dr. Dominguez Penuela has nothing to disclose.
Greer Waldrop, MD (UCSF) Dr. Waldrop has nothing to disclose.
Maria I. Reyes, MD (Hospital Simon Bolivar) Dr. Reyes has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Reyes has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Reyes has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Reyes has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Reyes has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Reyes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis.
David Acero-Garces, MD Dr. Acero-Garces has nothing to disclose.
Paula Barreras, MD (Cedars-Sinai Medical Center) Dr. Barreras has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. The institution of Dr. Barreras has received research support from Foundation for Sarcoidosis Research. The institution of Dr. Barreras has received research support from 好色先生.
Evan M. Johnson, MD (Piedmont Healthcare) No disclosure on file
H. Benjamin Larman H. Benjamin Larman has received personal compensation for serving as an employee of Infinity Bio. H. Benjamin Larman has or had stock in Infinity Bio.H. Benjamin Larman has received intellectual property interests from a discovery or technology relating to health care.
Samuel Pleasure, MD, PhD (UCSF) Dr. Pleasure has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. The institution of Dr. Pleasure has received research support from NINDS, NIMH, NIDA, National MS Society, Brain Research Foundation, John Merck Fund, Whitehall Foundation, Lupus Research Association, Juvenile Diabetes Research Foundation.
Kathryn Fitzgerald, PhD (Johns Hopkins University) Dr. Fitzgerald has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Setpoint Medical. The institution of Dr. Fitzgerald has received research support from NIH. The institution of Dr. Fitzgerald has received research support from National MS Society.
Michael R. Wilson, MD, FAAN (University of California San Francisco) Dr. Wilson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pfizer. Dr. Wilson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ouro Medicines. Dr. Wilson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Vertex Pharmaceuticals. Dr. Wilson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Indapta Therapeutics. Dr. Wilson has received personal compensation in the range of $50,000-$99,999 for serving as an officer or member of the Board of Directors for Delve Bio. Dr. Wilson has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Cambridge Medical Experts. Dr. Wilson has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Dunham Hallmark. Dr. Wilson has stock in Delve Bio. The institution of Dr. Wilson has received research support from Genentech / Roche. The institution of Dr. Wilson has received research support from NIH. The institution of Dr. Wilson has received research support from Novartis. The institution of Dr. Wilson has received research support from National Multiple Sclerosis Society. The institution of Dr. Wilson has received research support from Fanconi Anemia Research Foundation. The institution of Dr. Wilson has received research support from Department of Defense. The institution of Dr. Wilson has received research support from Chan Zuckerberg Initiative. The institution of Dr. Wilson has received research support from Kyverna Therapeutics. Dr. Wilson has received intellectual property interests from a discovery or technology relating to health care. Dr. Wilson has received intellectual property interests from a discovery or technology relating to health care. Dr. Wilson has received personal compensation in the range of $10,000-$49,999 for serving as a Expert Witness with US Dept of Justice.
Barney J. Stern, MD, FAAN (Johns Hopkins Outpatient Center) Dr. Stern has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for Foundation for Sarcoidosis Research. The institution of Dr. Stern has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN. The institution of Dr. Stern has received research support from NIH/NINDS. The institution of Dr. Stern has received research support from NIH/NINDS. The institution of Dr. Stern has received research support from NIH/NINDS. The institution of Dr. Stern has received research support from NIH/NINDS. Dr. Stern has received publishing royalties from a publication relating to health care.
Jeffrey M. Gelfand, MD, MS, FAAN (University of California, San Francisco) Dr. Gelfand has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Arialys. Dr. Gelfand has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ventyx Bio. An immediate family member of Dr. Gelfand has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Headache: The Journal of Head and Face Pain. The institution of Dr. Gelfand has received research support from Genentech/Roche. The institution of Dr. Gelfand has received research support from Vigil Neurosciences. An immediate family member of Dr. Gelfand has received publishing royalties from a publication relating to health care. Dr. Gelfand has received publishing royalties from a publication relating to health care. Dr. Gelfand has received publishing royalties from a publication relating to health care. Dr. Gelfand has a non-compensated relationship as a Trial Steering Committee Chairperson and member with Roche / Genentech that is relevant to AAN interests or activities.
Carlos A. Pardo-Villamizar, MD (Johns Hopkins U, Med Dept of Neurology) The institution of Dr. Pardo-Villamizar has received research support from National Institutes of Health. The institution of Dr. Pardo-Villamizar has received research support from Bart McLean Fund for Neuroimmunology Research .