Evaluation of NF-κB concentration in patients with tick-borne encephalitis, neuroborreliosis, anaplasmosis and Anaplasma phagocythophilum with tick-borne encephalitis virus co-infection

Objectives: The aim of the study was the evaluation of NF-kappa B concentration in serum and cerebrospinal fluid (CSF) of patients with diagnosis of tick-borne diseases: tick-borne encephalitis (TBE), neuroborreliosis (NB), anaplasmosis (ANA) and patients co-infected with tick-borne encephalitis virus and Anaplasma phagocythophilum (TBE + ANA). Additionally NF-kappa B concentration during acute and convalescent period was compared. Methods: Sixty-seven patients with diagnosis of tick-borne diseases were included in the study. The control group (CG) consisted of 18 patients hospitalized because of headaches and had lumbar puncture performed. The NF-kappa B was measured by human inhibitory subunit of NF-kappa B ELISA Kit during acute and convalescent period. Results: In serum the significant differences were observed only in patients with TBE + ANA co-infection. In CSF the concentration of NF-kappa B was significantly higher in patients with TBE, TBE + ANA co-infection, and patients with NB than in CG. Receiver operating characteristic (ROC) curves analysis showed that NF-kappa B concentration in CSF differentiated patients with NB with CG; patients co-infected with TBE and ANA with CG and patients with TBE with CG. NF-kappa B concentration in serum differentiated patients co-infected with TBE and ANA with NB and with ANA, with TBE and with CG. In TBE group the serum NF-kappa B concentration significantly decreased in convalescent period, while in NB and TBE groups significant CSF decrease of NF-kappa B concentration was observed. Conclusions: 1. Inflammatory process in the CNS results in the increase of NF-kappa B concentration in CSF, due to the damage of blood-brain barrier. 2. Co-infection of TBE + ANA increases NF-kappa B concentration in serum. 3. NF-kappa B concentration in serum may be useful in the differentiation of TBE + ANA co-infection with TBE and NB. 4. NF-kappa 3 concentration may be used to monitor TBE and NB treatment effectiveness. (C) 2016 Elsevier Ltd. All rights reserved.