Immunological studies of cerebrospinal fluid from patients with CNS symptoms after human papillomavirus vaccination

• 32 patients with prolonged CNS symptoms after HPV vaccination were studied.
• CSF levels of IL-4, IL-13, IL-17, IL-8 and MCP-1 were elevated.
• CSF levels of PDGF-bb and IL-12 were decreased.
• Antibodies to GluN2B-NT2, GluN2B-CT and GluN1-NT in CSF were increased.

In 32 patients with prolonged central nervous system symptoms after human papillomavirus (HPV) vaccination, we measured conventional and immunological markers in cerebrospinal fluid (CSF) and compared with the levels in disease controls. Our studies revealed significantly decreased chloride and neuron-specific enolase (NSE) levels in CSF of patients with CNS symptoms after HPV vaccination compared to disease controls. IL-4, IL-13, and CD4+ T cells increased significantly in patients, and IL-17 increased significantly from 12 to 24 months after symptom onset. Chemokines (IL-8 and MCP-1) were also elevated, but CD8+ T cells, PDGF-bb and IL-12 were reduced. Antibodies to GluN2B-NT2, GluN2B-CT and GluN1-NT increased significantly. These results suggest biological, mainly immunological, changes in the CSF of patients after HPV vaccination.

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