CXCL13 ELISA detects early neuroborreliosis
A new ELISA provides detection of the cytokine CXCL13 in cerebrospinal fluid (CSF) and is the first such assay worldwide to be approved for in vitro diagnostics. CXCL13 represents a novel biomarker for the early diagnosis of acute Lyme neuroborreliosis. It is present at high concentrations in CSF soon after the illness starts, even before intrathecal production of Borrelia antibodies can be detected. CXCL13 measurement thus helps to close the diagnostic gap between infection and a positive antibody test. CXCL13 is also a suitable marker for monitoring the disease course – its concentration decreases rapidly with successful therapy. The ELISA is based on a highly purified anti-CXCL13 monoclonal antibody. Measurements are made quantitatively using six calibrators. In a test panel of CSF samples from twelve neuroborreliosis patients the ELISA yielded strongly positive results in all cases, confirming its reliability and applicability. Acute neuroborreliosis is traditionally diagnosed using the clinical picture (meningitis, meningoradiculitis, neurological deficits), detection of an inflammatory CSF syndrome (e.g. pleocytosis blood-brain barrier dysfunction) and detection of intrathecal synthesis of Borrelia-specific antibodies. The antibody detection, however, unlike CXCL13 does not provide information on the activity of the disease. Furthermore, persistence of Borrelia-specific antibodies despite treatment can hinder reliable differentiation of past and active infections. The chemotactic cytokine CXCL13 is a cellular messenger which is produced by monocytes, macrophages and dendritic cells. It is an important chemoattractant for lymphocytes in the CSF. The detection of CXCL13 in CSF is of greatest relevance in the diagnosis of neuroborreliosis. However, increased levels of CXCL13 are also found in other inflammatory diseases of the CNS such as neurosyphilis, HIV, meningitis, streptococcus infections, toxoplasmosis and multiple sclerosis.
Supplier: EUROIMMUN AG
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