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The diagnostic significance of antibody specificity indices in multiple sclerosis and herpes virus induced diseases of the nervous system

Summary

The antibody specificity index (ASI) indicates the cerebrospinal fluid (CSF)/serum difference of antibody amounts per weight unit IgG (normal < 1.5). It has proven to be the most sensitive inflammation parameter in CSF analysis so far, more sensitive than the Western blot, the “oligoclonal” response, and the empirical differentiation of CSF immunoglobulins. By this diagnostic criterion, several benign viral meningitis cases were found to be caused by the varicella/zoster virus. The diagnostic relevance of local zoster antibody synthesis was greatest in ganglionitis cases, e.g., in zoster oticus sine herpete (facial paresis) and acute radicular syndromes of the elderly. The diagnostic significance of the local immune response against measles, rubella, and zoster antigens (MRZ response) was ascertained further. Together with oligoclonal gamma-globulin fractionation, there is now only 1 out of 100 multiple sclerosis (MS) patients left who has been found to have a normal CSF.

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Abbreviations

AB:

antibody

Alb:

albumin

ASI:

antibody specificity index

AU:

arbitrary unit

CSF:

cerebrospinal fluid

HIV:

human immunodeficiency virus

HSV:

herpes simplex virus

Ig:

immunoglobulin

Igloc:

locally synthesized immunoglobulin

MRI:

magnetic resonance imaging

MRZ:

measles, rubella, zoster

MS:

multiple sclerosis

MSL:

measles

Q:

CSF/serum concentration quotient

QLim:

limiting concentration quotient

RUB:

rubella

SDS:

sodium dodecyl sulfate

Ser:

serum

VZV:

varicella/zoster virus

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Felgenhauer, K., Reiber, H. The diagnostic significance of antibody specificity indices in multiple sclerosis and herpes virus induced diseases of the nervous system. Clin Investig 70, 28–37 (1992). https://doi.org/10.1007/BF00422934

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Key words

  • Cerebrospinal fluid antibodies
  • Multiple sclerosis
  • Herpes infections
  • Zoster
  • Facial paresis (Bell's palsy)