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Serum-CSF protein gradients, the blood-CSF barrier and the local immune response

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Summary

For the majority of proteins there is a steady state equilibrium between the serum and the CSF compartment which depends upon the hydrodynamic radii of the passively transferred molecules. For clinical purposes the serum—CSF concentration ratios of albumin (QA1b) anda 2-macroglobulin (Q a2M)have proven to be a reliable barrier parameter, which is more sensitive than the total protein level in certain diseases, e.g. disk protrusions, degenerative processes and metabolic disorders. The immunoglobulins G and A cope with the passive transfer mechanism in both normal conditions and all degrees of pure barrier impairments but deviate in cases with local immunoglobulin production. The method described produces a quantitative differentiation between the locally synthesized and the serum-derived immunoglobulin fractions. A humoral immune response within the central nervous system was found in certain stages of acute infectious diseases and with chronic inflammatory processes such as subacute sclerosing panencephalitis, neurolues and multiple sclerosis.

Zusammenfassung

Das Konzentrationsgefälle, das für die meisten Proteine zwischen Serum und Liquor besteht, hängt von den hydrodynamischen Radien ab. Für Routineuntersuchungen sind die Serum/Liquor-Quotienten von Albumin (QA1b) unda 2-Makroglobulin (Q a2M)verläßliche Parameter zur Beurteilung des Funktionszustandes der Blut-Liquor-Schranke. Bei einigen Erkrankungen, z.B. Bandscheibenvorfällen, degenerativen Prozessen und Stoffwechselstörungen, ist die Beurteilung der Blut-Liquor-Schranke ein empfindlicheres Kriterium als die Bestimmung des Gesamteiweißgehaltes. Die Immunglobuline G und A folgen unter normalen Bedingungen und allen Schweregraden reiner Schrankenstörungen den gleichen Permeabilitätsgesetzen. Eine Abweichung der Serum/Liquor-Immunglobulinquotienten wird in den Fällen beobachtet, in denen es zu einer lokalen Immunglobulinsynthese kommt. Die beschriebene Methode ermöglicht eine quantitative Differenzierung zwischen der lokal produzierten und der passiv aus dem Serum hindurchgetretenen Immunglobulinfraktion. Eine lokale humorale Immunantwort im Nervensystem wurde in gewissen Stadien akuter Infektionen und bei chronischen entzündlichen Prozessen wie der subakuten sklerosierenden Panencephalitis, der Neurolues und der Multiplen Sklerose beobachtet.

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  1. Universitäts-Nervenklinik Köln, Joseph-Stelzmann-Straße 9, D-5000, Köln 41, Germany

    G. Schliep & K. Felgenhauer

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  1. G. Schliep
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  2. K. Felgenhauer
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Schliep, G., Felgenhauer, K. Serum-CSF protein gradients, the blood-CSF barrier and the local immune response. J Neurol. 218, 77–96 (1978). https://doi.org/10.1007/BF02402169

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  • DOI: https://doi.org/10.1007/BF02402169

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