Institute for Hygiene and Applied Immunology, Medical University of Vienna, Austria.
Institute for Hygiene and Applied Immunology, Medical University of Vienna, Austria.
Ticks Tick Borne Dis. 2018 Jul;9(5):1137-1142. doi: 10.1016/j.ttbdis.2018.04.008. Epub 2018 Apr 20.
The aims of the study were to determine and compare the concentration of CXCL13 in cerebrospinal fluid (CSF) of patients with Lyme neuroborreliosis (LNB) and various other neurological disorders applying a Luminex based assay and ELISA, and to find factors associated with CXCL13 concentration. CSF samples obtained from four clinically well-defined groups of patients (proven LNB, suspected LNB, tick-borne encephalitis (TBE), and aseptic meningitis/meningoencephalitis other than TBE) - 25 samples per group - were analyzed. The performance of the Luminex recomBead CXCL13 assay (Microgen, Neuried, Germany) and ELISA (Euroimmun, Lübeck, Germany) was assessed by receiver operating characteristics. CXCL13 cut-off values were presented as functions of CSF lymphocyte/monocyte counts. Demographic variables, CSF findings, and history of erythema migrans were assessed as possible predictors for CXCL13 CSF concentrations by a general linear model. The calculated cut-off values determined by the maximum of the Youden index were >131 pg/mL for recomBead and >259 pg/mL for the ELISA. RecomBead showed a sensitivity of 88% (68.8-97.5%) and a specificity of 94% (83.5-98.7%). For the ELISA the corresponding values were 84% (63.9-95.5%) and 98% (89.4-99.9%). The CXCL13 concentration positively correlated with CSF lymphocyte/monocyte count and Borrelia-specific intrathecal antibody index (p < 0.05). High CXCL13 concentrations were only found in the group with proven LNB. CXCL13 levels above cut-off value were established in some patients with viral meningitis/meningoencephalitis but were not detected in patients with suspected LNB without pleocytosis. Applying a linearized cut-off of the CXCL13 concentration in the CSF which is dependent on the CSF cell count is a novel approach in the laboratory diagnosis of LNB.
本研究的目的是应用基于 Luminex 的测定法和 ELISA 来确定和比较莱姆神经Borreliosis (LNB) 患者和其他各种神经疾病患者脑脊液 (CSF) 中 CXCL13 的浓度，并找到与 CXCL13 浓度相关的因素。对来自四个临床定义明确的患者组（确诊 LNB、疑似 LNB、蜱传脑炎 (TBE) 和 TBE 以外的无菌性脑膜炎/脑膜脑炎）的 25 个样本/组的 CSF 样本进行分析。通过接受者操作特征来评估 Luminex recomBead CXCL13 测定法（Microgen，Neuried，德国）和 ELISA（Euroimmun，吕贝克，德国）的性能。CXCL13 截断值表示为 CSF 淋巴细胞/单核细胞计数的函数。通过一般线性模型评估人口统计学变量、CSF 发现和游走性红斑病史是否为 CSF CXCL13 浓度的可能预测因子。通过最大 Youden 指数确定的计算截断值>131 pg/mL 用于 recomBead，>259 pg/mL 用于 ELISA。recomBead 的灵敏度为 88%（68.8-97.5%），特异性为 94%（83.5-98.7%）。对于 ELISA，相应的值分别为 84%（63.9-95.5%）和 98%（89.4-99.9%）。CXCL13 浓度与 CSF 淋巴细胞/单核细胞计数和螺旋体特异性鞘内抗体指数呈正相关（p<0.05）。高 CXCL13 浓度仅在确诊 LNB 组中发现。在一些病毒性脑膜炎/脑膜脑炎患者中检测到高于临界值的 CXCL13 水平，但在无白细胞增多的疑似 LNB 患者中未检测到。在 LNB 的实验室诊断中，应用依赖于 CSF 细胞计数的 CSF 中 CXCL13 浓度的线性化截断值是一种新方法。
