Difficulties of interpreting Borrelia serology in patients with uveitis.

PURPOSE: We aimed to review all uveitis patients with a positive Borrelia serology to evaluate positive results in uveitis subtypes. Further we wanted to test a self-assembled Interferon gamma release assay (IGRA) as a possible supplement method in these patients. METHODS: Patients where serology for Borrelia was ordered from September 2005 to May 2008, were identified by database search. Patients with positive results in ELISA and Western Blot were retested by a self-assembled IGRA. Bayes Theorem was applied. RESULTS: Testing for Borrelia was ordered for 184 patients. 18 patients (9,8%) showed positive results. 11 were positive for IgG (5,9 %), 3 were positive for IgG and IgM (1,6 %) and 4 for IgM (2,1%). Applying Bayes Theorem, we calculated a posttest-probability of 9% in case of a positive test result. 16 of the 18 patients were retested by IGRA. None of them showed a positive result. CONCLUSIONS: A positive serology with uveitis as the only clinical symptom is not sufficient to confirm Borreliosis as 5,9 % of patients with uveitis and a positive IgG serology correspond to the normal spread of Borrelia in the population. Looking at posttest-probability shows a lot of false-positive test results when testing all uveitis patients for Borrelia routinely.

Altered glial cell line-derived neurotrophic factor (GDNF) concentrations in the brain of patients with depressive disorder: a comparative post-mortem study.

INTRODUCTION: A growing body of evidence suggests that the glial cell line-derived neurotrophic factor (GDNF) is involved in the aetiopathology of mood disorders. GDNF is a neurotrophic factor from the transforming growth factor-beta-family, playing a role in cell development and function in the limbic system. This is the first study to examine GDNF concentration in different brain regions of patients with depressive disorder (DD). MATERIAL AND METHODS: We used sandwich-ELISA-technique to ascertain GDNF concentration and Lowry assay for overall protein levels in post-mortem brain tissue of 7 patients with recurrent depressive disorder and 14 individuals without any neurological or psychiatric diagnoses. We included cortical regions as well as limbic area's (hippocampus, entorhinal cortex) basal ganglia (putamen, caudate nucleus), thalamus and cingulated gyrus. RESULTS: We found a significant increase in GDNF concentration in the parietal cortex of patients with DD compared to the control group. In other regions the trend of an increased GDNF concentration did not reach statistical difference. DISCUSSION: This proof of concept study supports previous findings of an alteration of the GDNF in patients with depressive disorder. However, for the first time a significant increase of GDNF in a cortical brain area was found in DD.

Evidence for oxidative stress in the frontal cortex in patients with recurrent depressive disorder--a postmortem study.

Prefrontal cortical (PFC) and hippocampal (HI) volume reductions have been consistently found in patients with recurrent depressive disorder (DD). Here we examine the possibility that oxidative stress, widely implicated in neuronal cell damage, may contribute to these brain structural changes. We compared manganese (Mn) and copper/zinc (Cu/Zn) superoxide dismutase (SOD) coenzyme concentrations in postmortem PFC and hippocampal brain tissue from 7 patients with DD and 7 neuropsychiatrically healthy controls using sandwich-type enzyme-linked immunosorbent assay (ELISA) technique. The concentration of Cu/Zn-SOD was significantly increased in the PFC but not in the hippocampus of patients. There was no significant change in Mn-SOD enzyme concentration in either region. Our findings contribute to the growing body of evidence implicating oxidative stress in the pathophysiology of depressive disorder.