脑脊液游离轻链作为神经莱姆病的诊断生物标志物。

Cerebrospinal fluid free light chains as diagnostic biomarker in neuroborreliosis.

机构信息

Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.

FH Campus Wien, University of Applied Sciences, Vienna, Austria.

出版信息

Clin Chem Lab Med. 2018 Jul 26;56(8):1383-1391. doi: 10.1515/cclm-2018-0028.

DOI:10.1515/cclm-2018-0028

PMID:29648995

Abstract

BACKGROUND

Free light chains (FLC) have been proposed as diagnostic biomarker in patients with inflammatory central nervous system diseases. The objective of this study was to investigate the diagnostic utility of intrathecal κ- and λ-FLC synthesis in patients with neuroborreliosis.

METHODS

κ- and λ-FLC were measured by nephelometry under blinded conditions in cerebrospinal fluid (CSF) and serum sample pairs of 34 patients with neuroborreliosis and compared to a cohort of 420 control patients. κ-FLC index was calculated as [CSF κ-FLC/serum κ-FLC]/[CSF albumin/serum albumin], and λ-FLC index in analogy.

RESULTS

κ-FLC and λ-FLC index were significantly elevated in patients with neuroborreliosis compared to the control group. At a specificity level of 95%, κ-FLC and λ-FLC index showed a diagnostic sensitivity of 88.2% and 100%. In comparison, IgM and IgG synthesis according to Reiber formula, IgG index >0.7 and OCB status reached a sensitivity of 83.9%, 44.1%, 58.8% and 64.7%.

CONCLUSION

These findings support the diagnostic value of intrathecal FLC synthesis in neuroborreliosis patients and demonstrate a valid, easy and rater-independent alternative for the detection of an intrathecal immunoglobulin production.

摘要

背景

游离轻链（FLC）已被提议作为炎症性中枢神经系统疾病患者的诊断生物标志物。本研究的目的是研究鞘内κ-和λ-FLC 合成在神经莱姆病患者中的诊断效用。

方法

在盲法条件下通过散射比浊法测量 34 例神经莱姆病患者的脑脊液（CSF）和血清样本对中的 κ-和 λ-FLC，并与 420 例对照患者的队列进行比较。κ-FLC 指数计算为 [CSF κ-FLC/血清 κ-FLC]/[CSF 白蛋白/血清白蛋白]，λ-FLC 指数类似。

结果

与对照组相比，神经莱姆病患者的 κ-FLC 和 λ-FLC 指数显着升高。在特异性为 95%的水平上，κ-FLC 和 λ-FLC 指数的诊断敏感性分别为 88.2%和 100%。相比之下，根据 Reiber 公式的 IgM 和 IgG 合成、IgG 指数>0.7 和 OCB 状态的敏感性分别为 83.9%、44.1%、58.8%和 64.7%。