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Lyme neuroborreliosis (LNB): New cerebrospinal fluid (CSF) biomarkers CXCL13 1 Single-centre, retrospective analysis: N=366 CSF samples: CXCL13: useful.

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Presentation on theme: "Lyme neuroborreliosis (LNB): New cerebrospinal fluid (CSF) biomarkers CXCL13 1 Single-centre, retrospective analysis: N=366 CSF samples: CXCL13: useful."— Presentation transcript:

1 Lyme neuroborreliosis (LNB): New cerebrospinal fluid (CSF) biomarkers CXCL13 1 Single-centre, retrospective analysis: N=366 CSF samples: CXCL13: useful tool for follow-up of LNB pts after antibiotic Tx: 1 Hytönen J. ECCMID 2014 abs. eP075 2 Gyllemark P. ECCMID 2014 abs. eP074 1 of 2 Data from poster * Tick-borne encephalitis (N=10), CNS varicella zoster infection (N=19), CNS herpes simplex infection (N=14), CNS HHV6 infection (N=3), CNS enterovirus infection (N=8); AI: Borrelia-specific antibody index; MS: multiple sclerosis; NI: neuroinflammatory; NS: not significant; ref.: reference; Tx: treatment

2 Lyme neuroborreliosis (LNB): New cerebrospinal fluid (CSF) biomarkers IL-17A 2 Single-centre retrospective analysis (2007-2009): N=178 suspected LNB pts Pts with definite LNB: If duration of symptoms >3 mo after Tx: CSF IL-17A levels significantly higher than if recovery within 3 mo after Tx (P=0.015) CXCL13 and IL-17A are promising CSF biomarkers of LNB disease activity; CXCL13 may also be useful for monitoring Tx response 1 Hytönen J. ECCMID 2014 abs. eP075 2 Gyllemark P. ECCMID 2014 abs. eP074 2 of 2 Data from poster

3 Incidence and clinical characteristics of Group A streptococcal meningitis (GASM) in adults Prospective, nationwide cohort study (the Netherlands; 2006-2013): –Inclusion criteria: ≥16 yr; positive cerebrospinal fluid (CSF) culture OR positive blood culture + ≥1 individual predictor of bacterial meningitis + clinical presentation compatible with bacterial meningitis –Exclusion criteria: nosocomial meningitis 2.0% (27/1,322) of community-acquired bacterial meningitis episodes were GASM Lucas MJ. ECCMID 2014 abs. P1453 1 of 2 Data from poster

4 Incidence and clinical characteristics of Group A streptococcal meningitis (GASM) in adults GASM is often preceded by otitis or sinusitis. It has high mortality and morbidity rates, and a high subdural empyema risk Lucas MJ. ECCMID 2014 abs. P1453 2 of 2 Data from poster

5 Meningococcal multi-component vaccine (4CMenB): predicted strain coverage in Europe 4CMenB (Bexsero ® ): novel multi-component protein-based vaccine against capsular group B meningococci (MenB): 4 major components: –Factor-H-binding protein: fHbp –Neisserial heparin binding antigen: NHBA –Neisserial adhesin A: NadA –Outer-membrane vesicles derived from strain NZ98/254 Large-scale epidemiological survey (2007-2008): N=1,052 invasive MenB strains from England + Wales, France, Germany, Italy, Norway Meningococcal antigen typing system (MATS) * → results linked to multilocus sequence typing and antigen sequence data Vogel U et al. Lancet Infect Dis 2013;13:416-25 1 of 2 *Donnelly J et al. Proc Natl Acad Sci USA 2010;107:19490-5

6 Meningococcal multi-component vaccine (4CMenB): predicted strain coverage in Europe Predicted strain coverage (MATS): 78% (95% CI: 63-90) 50% of strains/64% of covered strains could be targeted by bactericidal antibodies against ≥1 vaccine antigen Does generalisation of coverage apply to the rest of Europe? A multi-component vaccine may protect against a substantial proportion of invasive MenB strains isolated in Europe Vogel U et al. Lancet Infect Dis 2013;13:416-25 2 of 2

7 Relapsing post-herpes simplex virus (HSV) encephalitis (post-HSE): role in brain autoimmunity Single-centre study (2012-2013, Spain): 2 parts: 1. Prospective case study: N=5 pts with relapsing post-HSE Armangue T et al. Ann Neurol 2014;75:317-23 1 of 2 Abs: antibodies; Acyc: acyclovir; CycP: monthly intravenous cyclophosphamide; IVIg: intravenous immunoglobulins; IVMP: intravenous methylprednisolone; NA: not available; NMDAR: N-methyl-D-aspartate receptor; Ritux: rituximab

8 Relapsing post-herpes simplex virus (HSV) encephalitis (post-HSE): role in brain autoimmunity 2. Retrospective study: N=34 pts with definite or probable HSE Frequency of autoAbs ↑ over time in serum (P=0.004) and CSF (P=0.04) As NMDAR Abs appear between HSE and onset of relapsing post-HSE symptoms, HSE may trigger NMDA Abs and potentially other cell-surface/synaptic autoimmunity Armangue T et al. Ann Neurol 2014;75:317-23 2 of 2


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