Humoral Immunity in Multiple Sclerosis Cerebrospinal Fluid: Role of the Blood-Brain Barrier Integrity in the Detection of Intrathecally Synthesized Immunoglobulins
Five hundred neurological patients, among which 80 had Multiple Sclerosis, were examined for intrathecal synthesis of IgG, over one and an half year period. The detection of IgG oligoclonal bands in unconcentrated CSF was performed by thin-layer agarose IEF followed by double immunofixation, avidin-biotin complex amplification and peroxidase staining. To quantitate the IgG production, the IgG-index and the Intra-BBB IgG SYN rate were applied. The detection of IgG oligoclonal bands was found to be the most frequent immunological abnormality in MS CSF with normal blood-brain barrier function. In MS CSF with severe BBB damage there were not reliable indexes of intrathecal synthesis of IgG, since the formulae showed high percentage of false positive results and the detection of IgG oligoclonal bands was limited by the increase of the serum derived policlonal IgG. The intrathecal synthesis of IgA was analysed in 63 MS CSF by the application of the IgA-index. Few MS CSF showed an intrathecal synthesis of IgA and no correlation between positivity of IgA index and positivity of IgG-index was found.
KeywordsMultiple Sclerosis Oligoclonal Band Subacute Sclerosing Panencephalitis Intrathecal Synthesis Peroxidase Staining
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