Comparative analysis of albumin quotient and total CSF protein in immune-mediated neuropathies: a multicenter study on diagnostic implications
IntroductionBlood-cerebrospinal fluid (CSF) barrier dysfunction is pivotal for diagnosing immune-mediated neuropathies, especially in spinal nerve root inflammation. Typically, either total CSF protein or the CSF to serum albumin ratio (QAlb) is measured. Total CSF protein measurements have limitati...
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| Format: | Article |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1330484/full |
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| author | Tabea Seeliger Stefan Gingele Yunus Emre Güzeloglu Lena Heitmann Benjamin Lüling Felix Kohle Hannah Preßler Hannah Preßler Frauke Stascheit Frauke Stascheit Jeremias Motte Anna Lena Fisse Thomas Grüter Kalliopi Pitarokoili Thomas Skripuletz |
| author_facet | Tabea Seeliger Stefan Gingele Yunus Emre Güzeloglu Lena Heitmann Benjamin Lüling Felix Kohle Hannah Preßler Hannah Preßler Frauke Stascheit Frauke Stascheit Jeremias Motte Anna Lena Fisse Thomas Grüter Kalliopi Pitarokoili Thomas Skripuletz |
| author_sort | Tabea Seeliger |
| collection | DOAJ |
| description | IntroductionBlood-cerebrospinal fluid (CSF) barrier dysfunction is pivotal for diagnosing immune-mediated neuropathies, especially in spinal nerve root inflammation. Typically, either total CSF protein or the CSF to serum albumin ratio (QAlb) is measured. Total CSF protein measurements have limitations, notably its fixed reference value regardless of age, in contrast to the age-dependent reference for QAlb. Our goal was to evaluate both markers in patients with immune-mediated neuropathies.MethodsIn our multicenter research, we collected retrospective CSF data from patients suffering from immune-mediated neuropathies across four German research centers. These parameters were analyzed in relation to their clinical characteristics.ResultsOut of 419 samples, 36 (8.6%) displayed a notable variation between total CSF protein and QAlb values. A detailed analysis revealed that patients displaying elevated QAlb but normal total CSF protein levels were significantly younger at disease onset (p = 0.01), at the time of diagnosis (p = 0.005), and when undergoing lumbar puncture (p = 0.001) compared to patients with elevated CSF protein and normal QAlb levels. These effects were especially evident for the subgroup of samples derived by female patients.DiscussionOur work confirms the crucial role of QAlb in diagnosing immune-mediated neuropathies and particularly its efficacy as a marker for evaluating the blood-CSF barrier in patients with an earlier disease onset. Considering the significance of the albumin quotient, its assessment is especially advisable in younger patients of female sex to avoid missing a potential barrier dysfunction that might be falsely negative when using total protein. |
| first_indexed | 2024-03-08T15:51:54Z |
| format | Article |
| id | doaj.art-a8fed59ae5894e4ab8d6472affb0561d |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-08T15:51:54Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-a8fed59ae5894e4ab8d6472affb0561d2024-01-09T04:39:49ZengFrontiers Media S.A.Frontiers in Neurology1664-22952024-01-011410.3389/fneur.2023.13304841330484Comparative analysis of albumin quotient and total CSF protein in immune-mediated neuropathies: a multicenter study on diagnostic implicationsTabea Seeliger0Stefan Gingele1Yunus Emre Güzeloglu2Lena Heitmann3Benjamin Lüling4Felix Kohle5Hannah Preßler6Hannah Preßler7Frauke Stascheit8Frauke Stascheit9Jeremias Motte10Anna Lena Fisse11Thomas Grüter12Kalliopi Pitarokoili13Thomas Skripuletz14Department of Neurology, Hannover Medical School, Hannover, GermanyDepartment of Neurology, Hannover Medical School, Hannover, GermanyDepartment of Neurology, Hannover Medical School, Hannover, GermanyDepartment of Neurology, Hannover Medical School, Hannover, GermanyDepartment of Neurology, St Josef Hospital, Ruhr University Bochum, Bochum, GermanyDepartment of Neurology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, GermanyDepartment of Neurology with Experimental Neurology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität, Berlin, GermanyNeuroscience Clinical Research Center, Charité — Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Neurology with Experimental Neurology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität, Berlin, GermanyNeuroscience Clinical Research Center, Charité — Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Neurology, St Josef Hospital, Ruhr University Bochum, Bochum, GermanyDepartment of Neurology, St Josef Hospital, Ruhr University Bochum, Bochum, GermanyDepartment of Neurology, St Josef Hospital, Ruhr University Bochum, Bochum, GermanyDepartment of Neurology, St Josef Hospital, Ruhr University Bochum, Bochum, GermanyDepartment of Neurology, Hannover Medical School, Hannover, GermanyIntroductionBlood-cerebrospinal fluid (CSF) barrier dysfunction is pivotal for diagnosing immune-mediated neuropathies, especially in spinal nerve root inflammation. Typically, either total CSF protein or the CSF to serum albumin ratio (QAlb) is measured. Total CSF protein measurements have limitations, notably its fixed reference value regardless of age, in contrast to the age-dependent reference for QAlb. Our goal was to evaluate both markers in patients with immune-mediated neuropathies.MethodsIn our multicenter research, we collected retrospective CSF data from patients suffering from immune-mediated neuropathies across four German research centers. These parameters were analyzed in relation to their clinical characteristics.ResultsOut of 419 samples, 36 (8.6%) displayed a notable variation between total CSF protein and QAlb values. A detailed analysis revealed that patients displaying elevated QAlb but normal total CSF protein levels were significantly younger at disease onset (p = 0.01), at the time of diagnosis (p = 0.005), and when undergoing lumbar puncture (p = 0.001) compared to patients with elevated CSF protein and normal QAlb levels. These effects were especially evident for the subgroup of samples derived by female patients.DiscussionOur work confirms the crucial role of QAlb in diagnosing immune-mediated neuropathies and particularly its efficacy as a marker for evaluating the blood-CSF barrier in patients with an earlier disease onset. Considering the significance of the albumin quotient, its assessment is especially advisable in younger patients of female sex to avoid missing a potential barrier dysfunction that might be falsely negative when using total protein.https://www.frontiersin.org/articles/10.3389/fneur.2023.1330484/fullQAlbblood-cerebrospinal fluid-barrierCSFbarrier-dysfunctionimmune-mediated neuropathies |
| spellingShingle | Tabea Seeliger Stefan Gingele Yunus Emre Güzeloglu Lena Heitmann Benjamin Lüling Felix Kohle Hannah Preßler Hannah Preßler Frauke Stascheit Frauke Stascheit Jeremias Motte Anna Lena Fisse Thomas Grüter Kalliopi Pitarokoili Thomas Skripuletz Comparative analysis of albumin quotient and total CSF protein in immune-mediated neuropathies: a multicenter study on diagnostic implications Frontiers in Neurology QAlb blood-cerebrospinal fluid-barrier CSF barrier-dysfunction immune-mediated neuropathies |
| title | Comparative analysis of albumin quotient and total CSF protein in immune-mediated neuropathies: a multicenter study on diagnostic implications |
| title_full | Comparative analysis of albumin quotient and total CSF protein in immune-mediated neuropathies: a multicenter study on diagnostic implications |
| title_fullStr | Comparative analysis of albumin quotient and total CSF protein in immune-mediated neuropathies: a multicenter study on diagnostic implications |
| title_full_unstemmed | Comparative analysis of albumin quotient and total CSF protein in immune-mediated neuropathies: a multicenter study on diagnostic implications |
| title_short | Comparative analysis of albumin quotient and total CSF protein in immune-mediated neuropathies: a multicenter study on diagnostic implications |
| title_sort | comparative analysis of albumin quotient and total csf protein in immune mediated neuropathies a multicenter study on diagnostic implications |
| topic | QAlb blood-cerebrospinal fluid-barrier CSF barrier-dysfunction immune-mediated neuropathies |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1330484/full |
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