Boufidou Fotini, Vakrakou Aigli G, Anagnostouli Maria, Patas Kostas, Paraskevas Georgios, Chatzipanagiotou Stylianos, Stefanis Leonidas, Evangelopoulos Maria-Eleftheria
Neurochemistry and Biological Markers Unit, 1st Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 115 28 Athens, Greece.
Department of Biopathology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, 115 28 Athens, Greece.
Diagnostics (Basel). 2023 Jan 20;13(3):389. doi: 10.3390/diagnostics13030389.
The aim was to evaluate the performance of the latest quantitative marker for intrathecal IgG synthesis and to compare it with other established markers used for the same purpose. We retrospectively applied Auer's and Reiber's intrathecal IgG synthesis formulae in a cohort of 372 patients under investigation for central nervous system demyelination who had undergone lumbar puncture and oligoclonal bands (OCBs) detection for demonstrating intrathecal IgG synthesis. A ROC analysis revealed Auer's formula had lower sensitivity (68%) compared to Reiber's formula (83%) and IgG index (89%), in our cohort of patients that exhibited normal to mildly elevated albumin quotients (4.48 ± 3.93). By excluding possible sources of errors, we assume that Auer's formula is less sensitive than other established tools for the "prediction" of the detection of OCBs in routine cerebrospinal fluid (CSF) analyses due to the mathematical model used. Given the ability of Reiber's hyperbolic formula to describe the blood-CSF IgG distribution across a wide range of blood-brain barrier functionality, its use and the use of similar formulae are recommended for the discrimination between CNS-derived and blood-derived molecules in clinical laboratories.
目的是评估鞘内IgG合成最新定量标志物的性能，并将其与用于相同目的的其他既定标志物进行比较。我们回顾性地将奥尔（Auer）和赖伯（Reiber）鞘内IgG合成公式应用于372例接受腰椎穿刺和寡克隆带（OCB）检测以证明鞘内IgG合成的中枢神经系统脱髓鞘受调查患者队列中。一项ROC分析显示，在我们白蛋白商数正常至轻度升高（4.48±3.93）的患者队列中，与赖伯公式（83%）和IgG指数（89%）相比，奥尔公式的敏感性较低（68%）。通过排除可能的误差来源，我们认为由于所使用的数学模型，在常规脑脊液（CSF）分析中，奥尔公式在“预测”OCB检测方面比其他既定工具的敏感性更低。鉴于赖伯双曲线公式能够描述在广泛的血脑屏障功能范围内的血脑CSF IgG分布，建议在临床实验室中使用其及类似公式来区分中枢神经系统来源和血液来源的分子。
