Identification of protein biomarkers in host cerebrospinal fluid for differential diagnosis of tuberculous meningitis and other meningitis

鉴定宿主脑脊液中的蛋白质生物标志物以鉴别结核性脑膜炎和其他脑膜炎

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作者:Mailing Huang, Zeyu Ding, Wensheng Li, Weibi Chen, Yadong Du, Hongyan Jia, Qi Sun, Boping Du, Rongrong Wei, Aiying Xing, Qi Li, Naihui Chu, Liping Pan

Background and purpose

The diagnosis of tuberculous meningitis (TBM) is difficult due to the lack of sensitive

Conclusion

Our results confirmed the potential ability of CSF proteins to distinguish TBM from patients with non-TBM and provided a useful panel for the diagnosis of TBM.

Methods

Of the 112 suspected patients with TBM prospectively enrolled in the study, 32 patients with inconclusive diagnosis, non-infectious meningitis, and long-term treatment with hormones and immunosuppressants were excluded. The expression of 8 proteins in the CSF was analyzed using ELISA in 22 patients with definite TBM, 18 patients with probable TBM, and 40 patients with non-TBM.

Purpose

The diagnosis of tuberculous meningitis (TBM) is difficult due to the lack of sensitive

Results

Significant differences in the expression of 7 proteins were detected between the TBM and non-TBM groups (P < 0.01). Unsupervised hierarchical clustering (UHC) analysis revealed a disease-specific profile consisting of 7 differentially expressed proteins for TBM diagnosis, with an accuracy of 82.5% (66/80). Logistic regression with forward stepwise analysis indicated that a combination of 3 biomarkers (APOE_APOAI_S100A8) showed a better ability to discriminate TBM from patients with non-TBM [area under the curve (AUC) = 0.916 (95%CI: 0.857-0.976)], with a sensitivity of 95.0% (95%CI: 83.1-99.4%) and a specificity of 77.5% (95%CI: 61.5-89.2%).

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