脑脊液趋化因子 CXCL13 和抗 C6 肽抗体在莱姆神经Borreliosis 中的诊断性能。

Diagnostic performance of cerebrospinal fluid chemokine CXCL13 and antibodies to the C6-peptide in Lyme neuroborreliosis.

机构信息

Department of Clinical Chemistry, Kalmar County Hospital, SE-391 85 Kalmar, Sweden.

出版信息

J Infect. 2011 Feb;62(2):149-58. doi: 10.1016/j.jinf.2010.11.005. Epub 2010 Nov 16.

DOI:10.1016/j.jinf.2010.11.005

PMID:21087629

Abstract

OBJECTIVES

The aim of this study was to evaluate the chemokine CXCL13 and C6 antibodies separately and in combination in paired serum/cerebrospinal fluid (CSF) samples in the laboratory diagnosis of Lyme neuroborreliosis (LNB).

METHODS

A large retrospective material with paired serum/CSF samples from 261 patients with clinically suspected LNB was investigated. Patients were divided into three main diagnostic groups based on original results of CSF pleocytosis and intrathecal anti-borrelia antibodies (purified flagellum). Levels of CXCL13, albumin, total IgM and IgG in paired samples and C6 antibodies in CSF were compared across diagnostic groups.

RESULTS

A sensitivity of 99% and a specificity of 96% were achieved for CSF-Serum CXCL13 ratio. CSF-C6 antibodies performed with a sensitivity of 99% and a specificity of 88.0%. A combination of CSF-Serum CXCL13 ratio and CSF-C6 antibodies, evaluated in parallel, revealed a sensitivity of 99% and specificity of 98%.

CONCLUSIONS

This study confirms CSF-CXCL13 as a reliable marker of LNB and suggests improved diagnostic performance especially in children with possible LNB.

摘要

目的

本研究旨在分别评估趋化因子 CXCL13 和 C6 抗体，并结合配对血清/脑脊液 (CSF) 样本，用于实验室诊断莱姆神经Borreliosis (LNB)。

方法

对 261 例临床疑似 LNB 的患者进行了一项大型回顾性配对血清/CSF 样本研究。根据 CSF 白细胞增多和鞘内抗 Borrelia 抗体（纯化鞭毛）的原始结果，患者被分为三个主要诊断组。比较了配对样本中 CXCL13、白蛋白、总 IgM 和 IgG 水平以及 CSF 中的 C6 抗体在各诊断组中的差异。