From the Guidelines
Clinical Use of Beta (β) Transferrin Levels
Beta-2 transferrin levels are used to diagnose and confirm cerebrospinal fluid (CSF) leakage. A positive test result indicates the presence of CSF in bodily secretions, such as nasal or ear discharge, which can help identify the source of the leak 1. The test is typically ordered when a CSF leak is suspected, and it can help guide further treatment and management.
- The presence of b-2-transferrin in nasal secretions is a sensitive method of confirming CSF rhinorrhea 1.
- Detection of β2-transferrin or β-trace protein (specific to cerebrospinal fluid) in nasal secretions confirms a cerebrospinal fluid leak 1.
- A level of beta-2 transferrin is considered positive for CSF leakage, although the exact threshold value may vary.
- The test is useful in various clinical scenarios, including iatrogenic CSF leaks and spontaneous CSF leaks 1.
- In cases of suspected CSF leak, HRCT and MRI may also be used in conjunction with beta-2 transferrin testing to confirm the diagnosis and guide treatment 1.
From the Research
Clinical Use of Beta (β) Transferrin Levels
The clinical use of Beta (β) transferrin levels is primarily for detecting cerebrospinal fluid (CSF) leakage. Key points include:
- Beta-2 transferrin (β2TF) is a specific CSF glycoprotein biomarker used to determine CSF leakage when distinguished from serum sialotransferrin (sTF) 2, 3, 4, 5, 6
- The presence of β2TF in nasal or aural fluids can indicate a CSF leak, as it is normally only found in CSF, ocular fluids, and perilymph 2, 3, 5
- Immunofixation electrophoresis (IFE) and immunochromatographic assay (ICA) are methods used to detect and quantify β2TF in CSF and other bodily fluids 2, 4, 5
Diagnostic Applications
Diagnostic applications of β2TF include:
- Detection of CSF leakage in patients with suspected rhinorrhea or otorrhea 3, 6
- Confirmation of CSF fistulas in patients with posttraumatic, spontaneous, or postsurgical rhinorrhea 6
- Differentiation between CSF and other bodily fluids, such as nasal or aural secretions 2, 3, 5
Methodologies and Sensitivities
Different methodologies have been developed to detect and quantify β2TF, including:
- High-resolution immunofixation electrophoresis (IFE) on agarose gels 2, 5
- Immunochromatographic assay (ICA) using sialic acid-specific lectin 4
- Automated immunofixation electrophoresis systems 5
- These methods have varying sensitivities and specificities, with ICA showing 97.1% specificity and 96.2% sensitivity for detecting CSF leakage 4