Free Immunoglobulin Light Chains in Patients with Tick-Borne Encephalitis: Before and after Treatment

Gudowska-Sawczuk, Monika; Czupryna, Piotr; Moniuszko, Anna; Pancewicz, Sławomir; Mroczko, Barbara

doi:10.3390/jcm10132922

Cited by 12 publications

(11 citation statements)

References 20 publications

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“…Several studies used patients with inflammatory or infectious neurologic diseases as control groups for the comparison with MS patients [29,[44][45][46]51,[69][70][71]75,78]. Apart from that, there is one study, which systematically investigated KFLC concentrations in patients suffering from a viral CNS infection (tickborne-encephalitis) [136]. In this study, significant differences of CSF and serum KFLC concentrations before and after treatment were reported [136].…”

Section: Discussionmentioning

confidence: 92%

“…Apart from that, there is one study, which systematically investigated KFLC concentrations in patients suffering from a viral CNS infection (tickborne-encephalitis) [136]. In this study, significant differences of CSF and serum KFLC concentrations before and after treatment were reported [136]. Two studies investigated KFLC concentrations in samples of neuroborreliosis patients and found the determination of KFLC to be highly sensitive and specific [137,138].…”

Section: Discussionmentioning

confidence: 98%

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The Increasing Role of Kappa Free Light Chains in the Diagnosis of Multiple Sclerosis

Konen

Schwenkenbecher

Jendretzky

et al. 2021

Cells

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Free light chains (FLC) are a promising biomarker to detect intrathecal inflammation in patients with inflammatory central nervous system (CNS) diseases, including multiple sclerosis (MS). The diagnostic use of this biomarker, in particular the kappa isoform of FLC (“KFLC”), has been investigated for more than 40 years. Based on an extensive literature review, we found that an agreement on the correct method for evaluating KFLC concentrations has not yet been reached. KFLC indices with varying cut-off values and blood-CSF-barrier (QAlbumin) related non-linear formulas for KFLC interpretation have been investigated in several studies. All approaches revealed high diagnostic sensitivity and specificity compared with the oligoclonal bands, which are considered the gold standard for the detection of intrathecally synthesized immunoglobulins. Measurement of KFLC is fully automated, rater-independent, and has been shown to be stable against most pre-analytic influencing factors. In conclusion, the determination of KFLC represents a promising diagnostic approach to show intrathecal inflammation in neuroinflammatory diseases. Multicenter studies are needed to show the diagnostic sensitivity and specificity of KFLC in MS by using the latest McDonald criteria and appropriate, as well as standardized, cut-off values for KFLC concentrations, preferably considering non-linear formulas such as Reiber’s diagram.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 98%

The Increasing Role of Kappa Free Light Chains in the Diagnosis of Multiple Sclerosis

Konen

Schwenkenbecher

Jendretzky

et al. 2021

Cells

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“…For example, high-mobility group box 1 or chemokine (C-X-C motif) ligand (CXCL) 13 can be used to distinguish TBE meningitis from meningoencephalitis [15][16][17]. The levels of λ-free light chains, matrix metalloproteinase-9, or CXCL1 can be used as indicators of blood-brain barrier disruption [15,18,19]. Several other cytokines and chemokines, along with growth factors, monoamine neurotransmitters and other molecules, can be used as biomarkers for TBE [15,[20][21][22][23][24][25][26][27].…”

Section: Introductionmentioning

confidence: 99%

Serum and cerebrospinal fluid phosphorylated neurofilament heavy subunit as a marker of neuroaxonal damage in tick-borne encephalitis

Fořtová

Hönig

Palus

et al. 2022

Journal of General Virology

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Extensive axonal and neuronal loss is the main cause of severe manifestations and poor outcomes in tick-borne encephalitis (TBE). Phosphorylated neurofilament heavy subunit (pNF-H) is an essential component of axons, and its detection in cerebrospinal fluid (CSF) or serum can indicate the degree of neuroaxonal damage. We examined the use of pNF-H as a biomarker of neuroaxonal injury in TBE. In 89 patients with acute TBE, we measured CSF levels of pNF-H and 3 other markers of brain injury (glial fibrillary acidic protein, S100B and ubiquitin C-terminal hydrolase L1) and compared the results to those for patients with meningitis of other aetiology and controls. Serum pNF-H levels were measured in 80 patients and compared with findings for 90 healthy blood donors. TBE patients had significantly (P<0.001) higher CSF pNF-H levels than controls as early as hospital admission. Serum pNF-H concentrations were significantly higher in samples from TBE patients collected at hospital discharge (P<0.0001) than in controls. TBE patients with the highest peak values of serum pNF-H, exceeding 10 000 pg ml−1, had a very severe disease course, with coma or tetraplegia. Patients requiring intensive care had significantly higher serum pNF-H levels than other TBE patients (P<0.01). Elevated serum pNF-H values were also observed in patients with incomplete recovery (P<0.05). Peak serum pNF-H levels correlated positively with the duration of hospitalization (P=0.005). Measurement of pNF-H levels in TBE patients might be useful for assessing disease severity and determining prognosis.

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“…Additionally, knowing that the main source of proteins present in the CSF is serum, it has been speculated that increased concentrations of λ FLCs in the CSF result from increased permeability of the blood–brain barrier (BBB). The presence of TBEV-specific antibodies, as well as FLCs, in the CSF may also be an argument for the intrathecal synthesis of immunoglobulins in the CNS during TBEV infection [ 23 ].…”

Section: Resultsmentioning

confidence: 99%

Selected Biomarkers of Tick-Borne Encephalitis: A Review

Gudowska-Sawczuk

Mroczko

2021

IJMS

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Tick-borne encephalitis (TBE) is an acute disease caused by the tick-borne encephalitis virus. Due to the viral nature of the condition, there is no effective causal treatment for full-blown disease. Current and nonspecific TBE treatments only relieve symptoms. Unfortunately, the first phase of TBE is characterized by flu-like symptoms, making diagnosis difficult during this period. The second phase is referred to as the neurological phase as it involves structures in the central nervous system—most commonly the meninges and, in more severe cases, the brain and the spinal cord. Therefore, it is important that early markers of TBE that will guide clinical decision-making and the choice of treatment are established. In this review, we performed an extensive search of literature reports relevant to biomarkers associated with TBE using the MEDLINE/PubMed database. We observed that apart from routinely determined specific immunoglobulins, free light chains may also be useful in the evaluation of intrathecal synthesis in the central nervous system (CNS) during TBEV infection. Moreover, selected metalloproteinases, chemokines, or cytokines appear to play an important role in the pathogenesis of TBE as a consequence of inflammatory reactions and recruitment of white blood cells into the CNS. Furthermore, we reported promising findings on tau protein or Toll-like receptors. It was also observed that some people may be predisposed to TBE. Therefore, to understand the role of selected tick-borne encephalitis biomarkers, we categorized these factors and discussed their potential application in the diagnosis, prognosis, monitoring, or management of TBE.

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Free Immunoglobulin Light Chains in Patients with Tick-Borne Encephalitis: Before and after Treatment

Cited by 12 publications

References 20 publications

The Increasing Role of Kappa Free Light Chains in the Diagnosis of Multiple Sclerosis

The Increasing Role of Kappa Free Light Chains in the Diagnosis of Multiple Sclerosis

Serum and cerebrospinal fluid phosphorylated neurofilament heavy subunit as a marker of neuroaxonal damage in tick-borne encephalitis

Selected Biomarkers of Tick-Borne Encephalitis: A Review

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