Diagnostic performance of cerebrospinal fluid chemokine CXCL13 and antibodies to the C6-peptide in Lyme neuroborreliosis.

Abstract

OBJECTIVES:

The aim of this study was to evaluate the chemokine CXCL13 and C6 antibodies separately and in combination in paired serum/cerebrospinal fluid (CSF) samples in the laboratory diagnosis of Lyme neuroborreliosis (LNB).

METHODS:

A large retrospective material with paired serum/CSF samples from 261 patients with clinically suspected LNB was investigated. Patients were divided into three main diagnostic groups based on original results of CSF pleocytosis and intrathecal anti-borrelia antibodies (purified flagellum). Levels of CXCL13, albumin, total IgM and IgG in paired samples and C6 antibodies in CSF were compared across diagnostic groups.

RESULTS:

A sensitivity of 99% and a specificity of 96% were achieved for CSF-Serum CXCL13 ratio. CSF-C6 antibodies performed with a sensitivity of 99% and a specificity of 88.0%. A combination of CSF-Serum CXCL13 ratio and CSF-C6 antibodies, evaluated in parallel, revealed a sensitivity of 99% and specificity of 98%.

CONCLUSIONS:

This study confirms CSF-CXCL13 as a reliable marker of LNB and suggests improved diagnostic performance especially in children with possible LNB.

• Authors: Ivar Tjernberg, Anna J Henningsson, Ingvar Eliasson, Pia Forsberg, Jan Ernerudh
• Journal: The Journal of infection (J Infect) Vol. 62 Issue 2 Pg. 149-58 (Feb 2011) ISSN: 1532-2742 [Electronic] England
• PMID: 21087629 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2010 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Albumins
• Antibodies, Bacterial
• Chemokine CXCL13
• Immunoglobulin G
• Immunoglobulin M
• Peptide Fragments

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Albumins (analysis)
• Antibodies, Bacterial (analysis, blood, cerebrospinal fluid)
• Borrelia burgdorferi (immunology)
• Chemokine CXCL13 (blood, cerebrospinal fluid)
• Child
• Child, Preschool
• Female
• Humans
• Immunoglobulin G (blood, cerebrospinal fluid)
• Immunoglobulin M (blood, cerebrospinal fluid)
• Leukocytosis
• Lyme Neuroborreliosis (cerebrospinal fluid, diagnosis, immunology)
• Male
• Middle Aged
• Peptide Fragments (immunology)
• Retrospective Studies
• Sensitivity and Specificity