Detection of intrathecal antibodies to diagnose enterovirus infections of the central nervous system.

Abstract

BACKGROUND:

Enterovirus-D68 (EV-D68) predominantly causes respiratory disease. However, EV-D68 infections also have been associated with central nervous system (CNS) complications, most specifically acute flaccid myelitis (AFM). Diagnosing EV-D68-associated CNS disease is challenging since viral RNA is rarely detected in cerebrospinal fluid (CSF).

OBJECTIVE:

In order to determine an EV antibody index (AI), we evaluated the value of a commercially available quantitative ELISA to detect EV-specific antibodies in paired CSF and blood.

STUDY DESIGN:

Nine paired CSF and blood samples were obtained from patients with EV-D68-associated AFM or from patients with a confirmed EV-associated CNS disease. EV-specific antibodies were detected using a quantitative ELISA. A Reiber diagram analysis was performed, by which the AI was calculated. Subsequently, EV ELISA results were compared with an EV-D68 virus neutralization test.

RESULTS:

ELISA detected EV-specific antibodies in 1 out of the 3 patients with EV-D68-associated AFM and in 3 out of the 6 patients with confirmed EV-associated CNS disease. In these patients, the AI was indicative for intrathecal antibody production against enterovirus. Assay comparison showed that EV-D68 neutralizing antibody detection increased the sensitivity of EV-D68 antibody detection.

CONCLUSIONS:

A quantitative EV IgG ELISA in combination with Reiber diagram analysis and AI-calculation can be used as a diagnostic tool for EV-associated CNS disease, including EV-D68. An EV-D68 specific ELISA will improve the sensitivity of the tool. With the growing awareness that the detection of non-polio enteroviruses needs to be improved, diagnostic laboratories should consider implementation of EV serology.

• Authors: Syriam Sooksawasdi Na Ayudhya, Gregorius J Sips, Susanne Bogers, Lonneke M E Leijten, Brigitta M Laksono, Leonard C Smeets, Andrea Bruning, Kimberley Benschop, Katja Wolthers, Debby van Riel, Corine H GeurtsvanKessel
• Journal: Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology (J Clin Virol) Vol. 152 Pg. 105190 (07 2022) ISSN: 1873-5967 [Electronic] Netherlands
• PMID: 35640402 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.

Chemical References

• Antigens, Viral

Topics

• Antigens, Viral
• Central Nervous System
• Central Nervous System Viral Diseases (diagnosis)
• Enterovirus D, Human (genetics)
• Enterovirus Infections (complications)
• Humans
• Myelitis (diagnosis)
• Neuromuscular Diseases