title: Diagnostic performance of cerebrospinal fluid chemokine CXCL13 and antibodies to the C6-peptide in Lyme neuroborreliosis.
abstract: OBJECTIVE
  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.affiliation: Department of Clinical Chemistry, Kalmar County Hospital, SE-391 85 Kalmar, Sweden. itjernberg@hotmail.com
authors.forename: Ivar
authors.initials: I
authors.lastname: Tjernberg
authors.forename: Anna J
authors.initials: AJ
authors.lastname: Henningsson
authors.forename: Ingvar
authors.initials: I
authors.lastname: Eliasson
authors.forename: Pia
authors.initials: P
authors.lastname: Forsberg
authors.forename: Jan
authors.initials: J
authors.lastname: Ernerudh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000032:analysis; D000907:Antibodies, Bacterial / Q000032:analysis* / Q000097:blood / Q000134:cerebrospinal fluid; D025065:Borrelia burgdorferi / Q000276:immunology*; D054382:Chemokine CXCL13 / Q000097:blood / Q000134:cerebrospinal fluid*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000134:cerebrospinal fluid; D007075:Immunoglobulin M / Q000097:blood / Q000134:cerebrospinal fluid; D007964:Leukocytosis; D020852:Lyme Neuroborreliosis / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000276:immunology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D000418:Albumins; D000907:Antibodies, Bacterial; D054382:Chemokine CXCL13; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D010446:Peptide Fragments