The Reibergram for immunoglobulin A in dogs: Evaluation of intrathecal IgA synthesis using a quotient graph in dogs with neurological diseases

The Reibergram for immunoglobulin A in dogs: Evaluation of intrathecal IgA synthesis using a quotient graph in dogs with neurological diseases

Background Increased cerebrospinal fluid (CSF) protein concentration is a common finding in neurological diseases of dogs. Distinguishing between intrathecally‐produced proteins and proteins that have passed the blood‐CSF barrier because of barrier disruption facilitates diagnosis. Albumin is a micr...

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Bibliographic Details
Published in:Journal of veterinary internal medicine Vol. 37; no. 1; pp. 191 - 203
Main Authors: Püschel, Mirja L., Freise, Fritjof, Carlson, Regina, Tipold, Andrea, Nessler, Jasmin
Format: Journal Article
Language:English
Published: Hoboken, USA John Wiley & Sons, Inc 01-01-2023
Wiley
Subjects:
Albumin
Albumins - cerebrospinal fluid
Analysis
Animals
barrier dysfunction
Blood
blood‐CSF barrier
Cerebrospinal fluid
Cohort Studies
CSF
Dexmedetomidine
Diagnosis
Diagnostic tests
Dog Diseases
Dogs
immunoglobulin
Immunoglobulin A
Immunoglobulins
Meningitis
Metabolism
Micropeptides
Nervous system
Nervous system diseases
Nervous System Diseases - veterinary
Permeability
Physiological aspects
Physiology
Proteins
Retrospective Studies
SMALL ANIMAL
Steroids
Tomography
Veterinary medicine
Germany
blood-CSF barrier
immunoglobulin
barrier dysfunction
CSF
albumin
cerebrospinal fluid
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Summary:Background Increased cerebrospinal fluid (CSF) protein concentration is a common finding in neurological diseases of dogs. Distinguishing between intrathecally‐produced proteins and proteins that have passed the blood‐CSF barrier because of barrier disruption facilitates diagnosis. Albumin is a microprotein mainly produced extrathecally that can be used as a reference marker for blood‐CSF barrier dysfunction. Objectives Develop a quotient graph based on the CSF/serum quotient of albumin and immunoglobulin A (IgA; Reibergram) to visualize intrathecal IgA synthesis and blood‐CSF barrier dysfunction. Animals and Methods Retrospective single‐center cohort study. A hyperbolic function was developed using data from 6 healthy Beagles and 38 dogs with neurological diseases in which an isolated blood‐CSF barrier dysfunction was expected. The function was validated using data from 10 dogs with expected intrathecal IgA synthesis and was visualized as a quotient graph. Finally, the graph was used to evaluate data of 118 dogs with various neurological diseases. Results Within the Reibergram, the function QLimIgA=0.13QAlb2+11.9·10−6−1.01·10−3 describes the upper values of physiological IgA quotients. It detects diseases with expected intrathecal IgA synthesis with higher sensitivity (85%) and specificity (89%) than the IgA index. The upper value of the physiological albumin quotient is 2.22 and detects diseases with expected blood‐CSF barrier dysfunction (sensitivity: 81%; specificity: 88%). Conclusion and Clinical Importance The canine Reibergram can detect blood‐CSF barrier dysfunction and intrathecal IgA synthesis in the majority of cases. The graphical visualization simplifies data evaluation and makes it a feasible tool in routine CSF diagnostic testing.
Bibliography:Funding information
Deutsche Forschungsgemeinschaft, Grant/Award Number: 491094227; University of Veterinary Medicine Hannover, Foundation
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Funding information Deutsche Forschungsgemeinschaft, Grant/Award Number: 491094227; University of Veterinary Medicine Hannover, Foundation
ISSN:0891-6640
1939-1676
DOI:10.1111/jvim.16601