Marion DuPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Leesburg, VA 20176, USA.
J Vet Intern Med. 2011 Jan-Feb;25(1):138-42. doi: 10.1111/j.1939-1676.2010.0658.x. Epub 2010 Dec 14.
Diagnosis of equine protozoal myeloencephalitis (EPM) remains a challenge for equine practitioners. Current utilized methods have inadequate sensitivity and specificity, because of a high number of false positive results.
HYPOTHESIS/OBJECTIVE: Evaluation of antibody indices to Sarcocystis neurona should provide high sensitivity and specificity for diagnosis of EPM.
Archived samples from 29 clinical patients.
Archived serum and cerebrospinal fluid (CSF) samples from clinical patients with either EPM (14) or cervical vertebral compressive myelopathy (CVM) (15) were examined and tested for anti-S. neurona antibodies by the SnSAG2 ELISA. The results were used to calculate the antibody index (AI) and C-value. Sensitivity and specificity were calculated, and the AI, C-value, immunoglobulin G (IgG) concentrations, and anti-S. neurona titers compared. In addition, negative CSF was spiked in varying concentrations with blood from a horse with a high anti-S. neurona titer, and the tests repeated.
Results demonstrated that the IgG concentration, anti-S. neurona titer, AI, and C-value were significantly higher (P < .05) in horses with EPM than in those with CVM. Sensitivity and specificity of the AI was 71 and 100%, respectively, and that of the C-value was 86 and 100%, respectively. In addition, the AI and C-value from the samples spiked with S. neurona positive blood remained below 1 (eg, negative) in CSF with a red blood cell (RBC) count up to 10(5) RBC/μL. CONCLUSIONS/CLINICAL IMPORTANCE: Results of the study demonstrate the value of calculating the AI and C-value in the diagnosis of EPM in horses. In addition, the test is robust in the presence of blood contamination.
马的原虫性脑脊髓炎(EPM)的诊断仍然是兽医从业者的一项挑战。由于大量的假阳性结果,目前使用的方法灵敏度和特异性不足。
假设/目的:评估对 Sarcocystis neurona 的抗体指数应提供 EPM 诊断的高灵敏度和特异性。
29 例临床患者的存档样本。
对患有 EPM(14 例)或颈椎压迫性脊髓病(CVM)(15 例)的临床患者的存档血清和脑脊液(CSF)样本进行检查,并通过 SnSAG2 ELISA 检测抗 S. neurona 抗体。结果用于计算抗体指数(AI)和 C 值。计算了灵敏度和特异性,并比较了 AI、C 值、免疫球蛋白 G(IgG)浓度和抗 S. neurona 效价。此外,将高抗 S. neurona 效价马的血液以不同浓度混入阴性 CSF 中,并重复检测。
结果表明,EPM 马的 IgG 浓度、抗 S. neurona 效价、AI 和 C 值均显著高于 CVM 马(P <.05)。AI 的灵敏度和特异性分别为 71%和 100%,C 值的灵敏度和特异性分别为 86%和 100%。此外,在红细胞(RBC)计数高达 10(5)RBC/μL 的 CSF 中,即使混入了 S. neurona 阳性血液,AI 和 C 值仍保持在 1 以下(即阴性)。
结论/临床意义:研究结果表明,计算 AI 和 C 值在诊断马的 EPM 中有价值。此外,该检测在存在血液污染时具有很强的稳健性。