Serum and cerebrospinal fluid neurofilament light chain in patients with central nervous system infections caused by var
- PDF / 743,507 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 87 Downloads / 161 Views
Serum and cerebrospinal fluid neurofilament light chain in patients with central nervous system infections caused by varicella-zoster virus Tobias Tyrberg 1
&
Staffan Nilsson 2 & Kaj Blennow 3,4 & Henrik Zetterberg 3,4,5,6 & Anna Grahn 1
Received: 14 January 2020 / Revised: 14 January 2020 / Accepted: 29 July 2020 # The Author(s) 2020
Abstract Varicella-zoster virus (VZV) is a common cause of viral central nervous system (CNS) infection, and patients may suffer from severe neurological sequelae. The biomarker neurofilament light chain (NFL) is used for assessment of neuronal damage and is normally measured in cerebrospinal fluid (CSF). Novel methods have given the possibility to measure NFL in serum instead, which could be a convenient tool to estimate severity of disease and prognosis in VZV CNS infections. Here, we investigate the correlation of serum and CSF NFL in patients with VZV CNS infection and the association of NFL levels in serum and CSF with different VZV CNS entities. NFL in serum and CSF was measured in 61 patients who were retrospectively identified with neurological symptoms and VZV DNA in CSF detected by PCR. Thirty-three herpes zoster patients and 40 healthy blood donors served as control groups. NFL levels in serum and CSF correlated strongly in the patients with VZV CNS infection. Encephalitis was associated with significantly higher levels of NFL in both serum and CSF compared with meningitis and Ramsay Hunt syndrome. Surprisingly, herpes zoster controls had very high serum NFL levels, comparable with those shown in encephalitis patients. We show that analysis of serum NFL can be used instead of CSF NFL for estimation of neuronal injury in patients with VZV CNS infection. However, high levels of serum NFL also in patients with herpes zoster, without signs of CNS involvement, may complicate the interpretation. Keywords Varicella-zoster virus (VZV) . Central nervous system (CNS) . Biomarker . Encephalitis
Introduction
* Tobias Tyrberg [email protected] 1
Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
2
Department of Mathematical Statistics, Chalmers University of Technology, Gothenburg, Sweden
3
Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
4
Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
5
Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
6
UK Dementia Research Institute, London, UK
Varicella-zoster virus (VZV) is a neurotropic virus in the herpes family, and it is one of the most common viral agents causing infection in the central nervous system (CNS) (Granerod et al. 2010; Mailles et al. 2012; Persson et al. 2009). After primary infection, the virus establishes latency in sensory and autonomic ganglia. Reactivation can cause several different clinical manifestations involving the CNS, such as
Data Loading...
