Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Foundation, Hannover, Germany.
Institute for Biometry, Epidemiology, and Information Processing, University of Veterinary Medicine, Foundation, Hannover, Germany.
J Vet Intern Med. 2023 Jan;37(1):191-203. doi: 10.1111/jvim.16601. Epub 2022 Dec 12.
Increased cerebrospinal fluid (CSF) protein concentration is a common finding in neurological diseases of dogs. Distinguishing between intrathecally-produced proteins and proteins that have passed the blood-CSF barrier because of barrier disruption facilitates diagnosis. Albumin is a microprotein mainly produced extrathecally that can be used as a reference marker for blood-CSF barrier dysfunction.
Develop a quotient graph based on the CSF/serum quotient of albumin and immunoglobulin A (IgA; Reibergram) to visualize intrathecal IgA synthesis and blood-CSF barrier dysfunction.
Retrospective single-center cohort study. A hyperbolic function was developed using data from 6 healthy Beagles and 38 dogs with neurological diseases in which an isolated blood-CSF barrier dysfunction was expected. The function was validated using data from 10 dogs with expected intrathecal IgA synthesis and was visualized as a quotient graph. Finally, the graph was used to evaluate data of 118 dogs with various neurological diseases.
Within the Reibergram, the function describes the upper values of physiological IgA quotients. It detects diseases with expected intrathecal IgA synthesis with higher sensitivity (85%) and specificity (89%) than the IgA index. The upper value of the physiological albumin quotient is 2.22 and detects diseases with expected blood-CSF barrier dysfunction (sensitivity: 81%; specificity: 88%).
The canine Reibergram can detect blood-CSF barrier dysfunction and intrathecal IgA synthesis in the majority of cases. The graphical visualization simplifies data evaluation and makes it a feasible tool in routine CSF diagnostic testing.
脑脊液（CSF）蛋白浓度升高是犬类神经疾病的常见表现。区分鞘内产生的蛋白和因血脑屏障破坏而穿透血脑屏障的蛋白有助于诊断。白蛋白是一种主要在鞘外产生的微量蛋白，可用作血脑屏障功能障碍的参考标志物。
基于 CSF 与白蛋白和免疫球蛋白 A（IgA；Reibergram）的血清比值开发一个商图，以可视化鞘内 IgA 合成和血脑屏障功能障碍。
回顾性单中心队列研究。使用 6 只健康比格犬和 38 只预期存在孤立性血脑屏障功能障碍的神经疾病犬的数据，开发一个双曲线函数。使用 10 只预期存在鞘内 IgA 合成的犬的数据验证该函数，并将其可视化作为商图。最后，使用该图评估 118 只患有各种神经疾病的犬的数据。
在 Reibergram 中，该函数描述了生理性 IgA 比值的上限值。它以比 IgA 指数更高的敏感性（85%）和特异性（89%）检测到预期存在鞘内 IgA 合成的疾病。生理性白蛋白商的上限值为 2.22，可检测到预期存在血脑屏障功能障碍的疾病（敏感性：81%；特异性：88%）。
犬类 Reibergram 可在大多数情况下检测到血脑屏障功能障碍和鞘内 IgA 合成。图形可视化简化了数据评估，使其成为常规 CSF 诊断测试中的一种可行工具。
