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Macrophage migration inhibitory factor as a novel cerebrospinal fluid marker for neurosyphilis among HIV-negative patients.

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Title: Macrophage migration inhibitory factor as a novel cerebrospinal fluid marker for neurosyphilis among HIV-negative patients.
Authors: Lin, Li-Rong1,2, Lin, Dan-Hong3, Tong, Man-Li1, Liu, Li-Li1, Fan, Jin-Yi1, Zhu, Xiao-Zhen1, Gao, Kun1, Chen, Mei-Jun1, Zheng, Wei-Hong1, Zhang, Hui-Lin1, Li, Shu-Lian4, Lin, Hui-Ling4, Lin, Zhi-Feng4, Niu, Jian-Jun1,2 niujianjun211@xmu.edu.cn, Yang, Tian-Ci1,2 yangtianci@xmu.edu.cn
Source: Clinica Chimica Acta. Dec2016, Vol. 463, p103-108. 6p.
Subjects: Macrophage migration inhibitory factor, Sexually transmitted diseases, Lymphokines, Cerebrospinal fluid, Body fluids
Abstract: Background Neurosyphilis (NS) is difficult to diagnose, especially in syphilis patients with negative cerebrospinal fluid (CSF) rapid plasma reagin (RPR) or Venereal Disease Research Laboratory (VDRL) tests. Methods We conducted a cross-sectional study and an analysis of macrophage migration inhibitory factor (MIF) in syphilitic patients to identify a novel marker for the diagnosis of NS, with a focus on probable NS (NS with negative VDRL/RPR tests). For this purpose, CSF and serum MIF concentrations were determined in 43 NS and 43 syphilis/non-NS (N-NS) patients at the Zhongshan Hospital of the Medical College of Xiamen University from July 2014 to June 2015. Sixty-three blood donors were used as healthy controls. Results NS patients had higher CSF (median [IQR]: 8.77 ng/ml [4.76–19.13]) and serum (52.58 ng/ml [28.31–95.94]) MIF concentrations than N-NS patients did (4.08 [2.21–9.68] and 34.30 [19.77–59.75], respectively). Using a cut-off point of 6.63 ng/ml, CSF MIF had a sensitivity of 74.42% and a specificity of 67.74% for the diagnosis of NS. The sensitivity was higher than that of CSF RPR (39.53%) and increased protein (48.84%) tests and similar to that of CSF pleocytosis (67.44%). Additionally, the sensitivity of CSF MIF, which was 92.31% for the diagnosis of probable NS, was higher than that of CSF pleocytosis (65.38%) and increased protein (53.85%) tests. By integrating all CSF parameters (pleocytosis, increased protein and MIF), the sensitivity would be improved to 100% by parallel testing, which would avoid missed diagnoses. Moreover, the specificity would be improved to 100% by the serial testing algorithm, which would again avoid misdiagnosis. Conclusions CSF MIF concentrations can be used as a novel CSF marker to establish or exclude a diagnosis of NS. [ABSTRACT FROM AUTHOR]
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Database: Engineering Source
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Abstract:Background Neurosyphilis (NS) is difficult to diagnose, especially in syphilis patients with negative cerebrospinal fluid (CSF) rapid plasma reagin (RPR) or Venereal Disease Research Laboratory (VDRL) tests. Methods We conducted a cross-sectional study and an analysis of macrophage migration inhibitory factor (MIF) in syphilitic patients to identify a novel marker for the diagnosis of NS, with a focus on probable NS (NS with negative VDRL/RPR tests). For this purpose, CSF and serum MIF concentrations were determined in 43 NS and 43 syphilis/non-NS (N-NS) patients at the Zhongshan Hospital of the Medical College of Xiamen University from July 2014 to June 2015. Sixty-three blood donors were used as healthy controls. Results NS patients had higher CSF (median [IQR]: 8.77 ng/ml [4.76–19.13]) and serum (52.58 ng/ml [28.31–95.94]) MIF concentrations than N-NS patients did (4.08 [2.21–9.68] and 34.30 [19.77–59.75], respectively). Using a cut-off point of 6.63 ng/ml, CSF MIF had a sensitivity of 74.42% and a specificity of 67.74% for the diagnosis of NS. The sensitivity was higher than that of CSF RPR (39.53%) and increased protein (48.84%) tests and similar to that of CSF pleocytosis (67.44%). Additionally, the sensitivity of CSF MIF, which was 92.31% for the diagnosis of probable NS, was higher than that of CSF pleocytosis (65.38%) and increased protein (53.85%) tests. By integrating all CSF parameters (pleocytosis, increased protein and MIF), the sensitivity would be improved to 100% by parallel testing, which would avoid missed diagnoses. Moreover, the specificity would be improved to 100% by the serial testing algorithm, which would again avoid misdiagnosis. Conclusions CSF MIF concentrations can be used as a novel CSF marker to establish or exclude a diagnosis of NS. [ABSTRACT FROM AUTHOR]
ISSN:00098981
DOI:10.1016/j.cca.2016.10.018