Abstract

There have been suggestions that tick-borne encephalitis (TBE) may cause neurodenenerative changes in the brain. The aim of this study was the assessment of the tau protein concentration in cerebrospinal fluid (CSF) of patients with different clinical forms of TBE. The concentration of tau protein in CSF was determined using Fujirebio tests (Ghent, Belgium) in 35 patients with TBE: group I—patients with meningitis (n = 16); group II—patients with meningoencephalitis (n = 19). None of the patients reported any neurodegenerative disorder that could affect the results of the study. The control group (CG) consisted of 10 patients in whom inflammatory process in central nervous system was excluded. Tau protein concentration in CSF before treatment did not differ significantly between the examined groups, while its concentration was significantly higher in encephalitis group than in CG after 14 days of treatment. Significant increase in tau protein concentration after treatment was observed in both examined groups. The comparison between the group of patients who fully recovered and patients who presented with persistent symptoms on discharge showed significant differences in tau protein concentration before and after treatment. ROC curve analysis indicates that CSF tau protein concentration before treatment may predict complicated course of the disease with 90.9% specificity and 80% sensitivity, while after treatment, specificity became 72.7% and 71.4% for sensitivity. Correlation analysis showed that in TBE patients (both meningoencephalitis and meningitis groups), CSF pleocytosis before treatment correlated negatively with tau protein concentration in CSF. (1) Neurodegeneration process is present in TBE encephalitis. (2) Tau protein concentration may be used as a predictor of complicated course of TBE.

Highlights

  • Tick-borne encephalitis (TBE) is an infectious central nervous system (CNS) disease caused by tick-borne encephalitis virus (TBEV) of Flavivirus genus, transmitted by Ixodes ticks

  • (2) Tau protein concentration may be used as a predictor of complicated course of TBE

  • Tick-borne encephalitis (TBE) is an infectious CNS disease caused by tick-borne encephalitis virus (TBEV) of Flavivirus genus, transmitted by Ixodes ticks

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Summary

Introduction

Tick-borne encephalitis (TBE) is an infectious CNS disease caused by tick-borne encephalitis virus (TBEV) of Flavivirus genus, transmitted by Ixodes ticks. There are between 200 and 300 cases registered per year in Poland. The majority of cases is noted in the Podlaskie Province. TBE may take different clinical courses from asymptomatic to life-threatening and/or causing permanent neurological and cognitive deficits. We can differentiate three distinct clinical forms of TBE: meningitis, meningoencephalitis, meningoencephalomyelitis [1, 2]. We observed that neurodegenerative process is present in the course of TBE, as there was an increased production of neuron-specific enolase (NSE) in CSF [3]

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