Background: Cerebrospinal fluid (CSF) Real Time-Quaking Induced Conversion (RT-QuIC) has a high degree of sensitivity and specificity for the diagnosis of sporadic Creutzfeldt-Jakob Disease (sCJD) and this has led to it being included in revised European CJD Surveillance network diagnostic criteria for sCJD. As CSF RT-QuIC becomes more widely established, it is crucial that the analytical performance of individual laboratories is consistent. The aim of this ring-trial was to ascertain the degree of concordance between European countries undertaking CSF RT-QuIC. Methods: Ten identical CSF samples, seven from probable or neuropathologically confirmed sCJD and three from non-CJD cases, were sent to 13 laboratories from 11 countries for RT-QuIC analysis. A range of instrumentation and different recombinant prion protein substrates were used. Each laboratory analysed the CSF samples blinded to the diagnosis and reported the results as positive or negative. Results: All 13 laboratories correctly identified five of the seven sCJD cases and the remaining two sCJD cases were identified by 92% of laboratories. Of the two sCJD cases that were not identified by all laboratories; one had a disease duration greater than 26 months with a negative 14-3-3, whilst the remaining case had a 4 month disease duration and a positive 14-3-3. A single false positive CSF RT-QuIC result was observed in this study. Conclusions: This study shows that CSF RT-QuIC demonstrates an excellent concordance between centres, even when using a variety of instrumentation, rPrP substrates and CSF volumes. We recommend the adoption of CSF RT-QuIC by all CJD surveillance centres.

Concordance of CSF RT-QuIC across the European Creutzfeldt-Jakob Disease surveillance network

Bongianni, Matilde;Perra, Daniela;Zanusso, Gianluigi;
2022-01-01

Abstract

Background: Cerebrospinal fluid (CSF) Real Time-Quaking Induced Conversion (RT-QuIC) has a high degree of sensitivity and specificity for the diagnosis of sporadic Creutzfeldt-Jakob Disease (sCJD) and this has led to it being included in revised European CJD Surveillance network diagnostic criteria for sCJD. As CSF RT-QuIC becomes more widely established, it is crucial that the analytical performance of individual laboratories is consistent. The aim of this ring-trial was to ascertain the degree of concordance between European countries undertaking CSF RT-QuIC. Methods: Ten identical CSF samples, seven from probable or neuropathologically confirmed sCJD and three from non-CJD cases, were sent to 13 laboratories from 11 countries for RT-QuIC analysis. A range of instrumentation and different recombinant prion protein substrates were used. Each laboratory analysed the CSF samples blinded to the diagnosis and reported the results as positive or negative. Results: All 13 laboratories correctly identified five of the seven sCJD cases and the remaining two sCJD cases were identified by 92% of laboratories. Of the two sCJD cases that were not identified by all laboratories; one had a disease duration greater than 26 months with a negative 14-3-3, whilst the remaining case had a 4 month disease duration and a positive 14-3-3. A single false positive CSF RT-QuIC result was observed in this study. Conclusions: This study shows that CSF RT-QuIC demonstrates an excellent concordance between centres, even when using a variety of instrumentation, rPrP substrates and CSF volumes. We recommend the adoption of CSF RT-QuIC by all CJD surveillance centres.
Cerebrospinal fluid (CSF)
Real-time Quaking Induced Conversion (RT-QuIC)
Creutzfeldt-Jakob disease (CJD)
prion
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/1064058
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