Role Of Vitamin D-Binding Protein As A Diagnostic Biomarker For Patients With Acute Meningitis

Abstract

Background Acute inflammation of the pia, arachnoids, and fluid in the brain's subarachnoid space is known as meningitis. It is challenging to diagnose because there is no diagnostic biomarker. The purpose of this study was to assess the viability of utilizing vitamin-D binding protein (VDBP) in cerebrospinal fluid (CSF) as a novel possible diagnostic for meningitis diagnosis. Patients and methods: A cross-section study was conducted on 48 patients with manifestations suggesting an acute meningitis, 28 patients with an acute meningitis who were divided into bacterial group containing 10 patients and viral group containing 18 patients confirmed by laboratory investigations and 20 patients who were clinically suspected as an acute meningitis, but excluded by laboratory investigations, the study was conducted within the period from April 2022 to November 2022. CSF and blood samples were obtained in pairs. CSF and serum VDBP were measured in the 3 groups. CSF VDBP concentrations were compared versus serum VDBP concentrations according to disease (viral meningitis vs. bacterial meningitis vs non-meningitis). Receiver operating characteristic (ROC) analysis for diagnosing meningitis using CSF VDBP concentration was performed. Results: There was a statistical significant difference as regard the CSF VDBP (P<0.01) was found between viral, bacterial and control groups (2.49±.65, 2.43±.55 and 1.74±.25μg/mL, respectively). There was a statistical significant difference (P<0.05) in serum VDBP between the viral, bacterial and control groups (214.5±36.5, 197.4±54.8 an[1]d 174.3±40.4 μg/mL, respectively). ROC curve analysis showed that the optimum cut-off level of CSF VDBP for diagnosing meningitis was 1.94 μg/mL with a sensitivity of 82.1% and specificity of 85%. AUC of CSF VDBP was 0.865 (95% CI: 0.761–0.969). Conclusion: The amount of Vitamin-D Binding Protein (VDBP) in cerebrospinal fluid (CSF) showed outstanding diagnostic performance. It might be used as a diagnostic marker for acute meningitis.