1887

Abstract

Extensive axonal and neuronal loss is the main cause of severe manifestations and poor outcomes in tick-borne encephalitis (TBE). Phosphorylated neurofilament heavy subunit (pNF-H) is an essential component of axons, and its detection in cerebrospinal fluid (CSF) or serum can indicate the degree of neuroaxonal damage. We examined the use of pNF-H as a biomarker of neuroaxonal injury in TBE. In 89 patients with acute TBE, we measured CSF levels of pNF-H and 3 other markers of brain injury (glial fibrillary acidic protein, S100B and ubiquitin C-terminal hydrolase L1) and compared the results to those for patients with meningitis of other aetiology and controls. Serum pNF-H levels were measured in 80 patients and compared with findings for 90 healthy blood donors. TBE patients had significantly (<0.001) higher CSF pNF-H levels than controls as early as hospital admission. Serum pNF-H concentrations were significantly higher in samples from TBE patients collected at hospital discharge (<0.0001) than in controls. TBE patients with the highest peak values of serum pNF-H, exceeding 10 000 pg ml, had a very severe disease course, with coma or tetraplegia. Patients requiring intensive care had significantly higher serum pNF-H levels than other TBE patients (<0.01). Elevated serum pNF-H values were also observed in patients with incomplete recovery (<0.05). Peak serum pNF-H levels correlated positively with the duration of hospitalization (=0.005). Measurement of pNF-H levels in TBE patients might be useful for assessing disease severity and determining prognosis.

Funding
This study was supported by the:
  • Grantová Agentura České Republiky (Award 20-30500S)
    • Principle Award Recipient: PalusMartin
  • Grantová Agentura České Republiky (Award 20-14325S)
    • Principle Award Recipient: RuzekDaniel
  • Ministerstvo Zdravotnictví Ceské Republiky (Award NV19-05-00457)
    • Principle Award Recipient: DanielRuzek
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/content/journal/jgv/10.1099/jgv.0.001743
2022-05-04
2024-12-13
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