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Bacteriology

Comparative Analysis of the Euroimmun CXCL13 Enzyme-Linked Immunosorbent Assay and the ReaScan Lateral Flow Immunoassay for Diagnosis of Lyme Neuroborreliosis

Katharina Ziegler, Anca Rath, Christoph Schoerner, Renate Meyer, Thomas Bertsch, Frank Erbguth, Christian Bogdan, Jörg Steinmann, Jürgen Held
Brad Fenwick, Editor
Katharina Ziegler
aInstitute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, Nuremberg, Germany
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Anca Rath
bMikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Christoph Schoerner
bMikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Renate Meyer
bMikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Thomas Bertsch
cInstitute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, Paracelsus Medical University, Klinikum Nürnberg, Nuremberg, Germany
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Frank Erbguth
dClinic of Neurology, Paracelsus Medical University, Klinikum Nürnberg, Nuremberg, Germany
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Christian Bogdan
bMikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
eMedical Immunology Campus Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Jörg Steinmann
aInstitute of Clinical Hygiene, Medical Microbiology and Infectiology, Paracelsus Medical University, Klinikum Nürnberg, Nuremberg, Germany
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Jürgen Held
bMikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Brad Fenwick
University of Tennessee at Knoxville
Roles: Editor
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DOI: 10.1128/JCM.00207-20
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ABSTRACT

Diagnosis of Lyme neuroborreliosis (LNB) is challenging, as long as Borrelia-specific intrathecal antibodies are not yet detectable. The chemokine CXCL13 is elevated in the cerebrospinal fluid (CSF) of LNB patients. Here, we compared the performances of the Euroimmun CXCL13 enzyme-linked immunosorbent assay (CXCL13 ELISA) and the ReaScan CXCL13 lateral flow immunoassay (CXCL13 LFA), a rapid point-of-care test, to support the diagnosis of LNB. In a dual-center case-control study, CSF samples from 90 patients (34 with definite LNB, 10 with possible LNB, and 46 with other central nervous system [CNS] diseases [non-LNB group]) were analyzed with the CXCL13 ELISA and the CXCL13 LFA. Classification of patients followed the European Federation of Neurological Societies (EFNS) guidelines on LNB. The CXCL13 ELISA detected elevated CXCL13 levels in all patients with definite LNB (median, 1,409 pg/ml) compared to the non-LNB controls (median, 20.7 pg/ml; P < 0.0001), with a sensitivity of 100% and a specificity of 84.8% (cutoff value, 78.6 pg/ml; area under the receiver operating characteristic [ROC] curve, 0.93). Similarly, the CXCL13 LFA yielded elevated CXCL13 levels in 31 patients with definite LNB (median arbitrary value, 223.5) compared to the non-LNB control patients (median arbitrary value, 0; P < 0.0001) and had a sensitivity and specificity of 91.2% and 93.5%, respectively (cutoff arbitrary value, 22.5; area under the ROC curve, 0.94). The correlation between the CXCL13 levels obtained by ELISA and LFA was strong (Spearman correlation coefficient r = 0.89; P < 0.0001). The CXCL13 ELISA and the CXCL13 LFA are comparable diagnostic tools for the detection of CXCL13 in the CSF of patients with definite LNB. The advantage of the CXCL13 LFA is the shorter time to result.

FOOTNOTES

    • Received 5 February 2020.
    • Returned for modification 18 March 2020.
    • Accepted 12 May 2020.
    • Accepted manuscript posted online 20 May 2020.
  • Supplemental material is available online only.

  • Copyright © 2020 American Society for Microbiology.

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Comparative Analysis of the Euroimmun CXCL13 Enzyme-Linked Immunosorbent Assay and the ReaScan Lateral Flow Immunoassay for Diagnosis of Lyme Neuroborreliosis
Katharina Ziegler, Anca Rath, Christoph Schoerner, Renate Meyer, Thomas Bertsch, Frank Erbguth, Christian Bogdan, Jörg Steinmann, Jürgen Held
Journal of Clinical Microbiology Aug 2020, 58 (9) e00207-20; DOI: 10.1128/JCM.00207-20

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Comparative Analysis of the Euroimmun CXCL13 Enzyme-Linked Immunosorbent Assay and the ReaScan Lateral Flow Immunoassay for Diagnosis of Lyme Neuroborreliosis
Katharina Ziegler, Anca Rath, Christoph Schoerner, Renate Meyer, Thomas Bertsch, Frank Erbguth, Christian Bogdan, Jörg Steinmann, Jürgen Held
Journal of Clinical Microbiology Aug 2020, 58 (9) e00207-20; DOI: 10.1128/JCM.00207-20
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KEYWORDS

neuroborreliosis
Lyme disease
meningitis
Borrelia burgdorferi
biomarker
CSF
neuroborreliosis

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