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The Cerebrospinal Fluid Interleukin-6/Interleukin-10 Ratio Differentiates Pediatric Tick-borne Infections
Sofia Ygberg1, Åsa Fowler2, Gordana Bogdanovic3
1From the Neuropediatric Department, Institution for Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Insights
A novel cytokine ratio in cerebrospinal fluid can rapidly differentiate between tick-borne encephalitis (TBE) virus and Borrelia burgdorferi infections. This interleukin-6/interleukin-10 ratio aids early diagnosis and treatment of central nervous system infections.
Area of Science:
- Neuroscience
- Immunology
- Infectious Diseases
Background:
- Tick-borne pathogens like Borrelia burgdorferi and tick-borne encephalitis (TBE) virus cause central nervous system infections.
- Current diagnostics rely on CSF analysis and serology, which can be slow and yield false negatives, delaying treatment.
- Cytokine analysis offers a promising avenue for faster clinical diagnosis.
Purpose of the Study:
- To investigate the utility of cytokine profiles in differentiating TBE virus infection from neuroborreliosis.
- To identify specific cytokine markers for rapid diagnosis of tick-borne central nervous system infections.
Main Methods:
- Analyzed 15 cytokines and chemokines in cerebrospinal fluid (CSF) from children with TBE, neuroborreliosis, and controls.
- Utilized Luminex technology for high-throughput cytokine measurement.
- Compared cytokine levels between diagnostic groups.
Main Results:
- Children with TBE showed significantly higher levels of interleukin-6 (IL-6) compared to neuroborreliosis or controls.
- Children with neuroborreliosis had elevated levels of IL-7, IL-8, IL-10, and IL-13 compared to TBE or controls.
- The ratio of IL-6 to IL-10 differed significantly between TBE and neuroborreliosis groups.
Conclusions:
- The IL-6/IL-10 ratio in CSF can serve as a rapid diagnostic indicator for suspected tick-borne infections.
- This cytokine ratio can facilitate prompt and accurate treatment initiation.
- The IL-6/IL-10 ratio may support clinical suspicion even with negative serology results.
Background:
Borrelia burgdorferi and tick-borne encephalitis (TBE) virus are 2 types of tick-borne pathogens that can cause central nervous system infection. Routine diagnostics have so far included analysis of cerebrospinal fluid (CSF) cell numbers, CSF serology for Borrelia burgdorferi and serum serology for TBE virus. However, early diagnosis may be difficult based on antibody detection which takes time to analyze, and with the possibility of false negative results, thus delaying treatment. Cytokine analyses are becoming increasingly available in clinical routine care and may offer important information.
Methods:
Fifteen cytokines and chemokines were measured in the CSF from the diagnostic lumbar puncture of 37 children with TBE, 34 children with neuroborreliosis and 19 children without evidence of central nervous system infection, using Luminex technology.
Results:
Significantly higher levels of proinflammatory interleukin-6 were detected in the samples from TBE-infected children, when compared with neuroborreliosis or controls. In comparison, children with neuroborreliosis had significantly higher levels of interleukin-7, interleukin-8, interleukin-10, and interleukin-13 when compared with TBE infected or controls. Furthermore, the ratio between interleukin-6 and interleukin-10 was significantly different between the 2 types of tick-borne infections.
Conclusions:
The interleukin-6/interleukin-10 ratio can be used as a rapid diagnostic cue upon suspected tick-borne infection, enabling fast and correct treatment. Also, in serology-negative results, such information may strengthen a clinical suspicion.
