Electrophoretic morphology of gamma globulins in cerebrospinal fluid of multiple sclerosis and other diseases of the nervous system

Abstract

and immunochemical determination27-3b), the significance of the results has not been fully appreciated, and the data have sometimes been inconclusive.Study of the literature devoted to this subject is diacult because the selection of patients has varied and because clinical criteria have varied from one author to the next.Few authors have employed more than one technique on the same CSF sample except to compare the colloidal c u r v e s 5~8~9~1 0~~6~2 8 to one of the newer techniques. It is clear that there is need for reevaluation of existing literature.The present work is based on results obtained by agar gel electrophoresis and is concerned with a correlation between clinical parameters and different electrophoretic patterns of CSF proteins. hlATERIALS AND METHODSPatient population. We reviewed the records of 2,043 patients who had been admitted to 982Neurology / Volume 20 / October 1970 the Neurological Department of the University Clinics and in whom CSF protein electrophoresis was performed. In 323 patients, the diagnosis was multiple sclerosis, designated as either definite, probable, or possible. The other patients were assigned to one of the diagnostic categories listed in Table 1. The diagnoses were based on clinical examination and technical procedures such as myelography, pneumoencephalography, arteriography, cerebral scintigraphy, electroencephalography, and routine CSF examination. The results of CSF protein electrophoresis were not considered in making the diagnosis. The different clinical and laboratory data concerning these cases of MS were plotted on IBM cards.Tentative correlations were established between electrophoretic patterns of CSF proteins and the duration and course of the disease, degree of disability, and diagnostic category, as well as the CSF cell count and total protein content. No attempt was made to categorize

Comparison of agar gel electrophoresis and isoelectric focusing in multiple sclerosis and subacute sclerosing panencephalitis

“…Many studies have attempted, with limited success, to correlate the presence and number of oligoclonal IgG bands as shown by AGE [2,10,11,13,14,[22][23][24][25][26]29,31,341 and IEF [ 3 ,8 ,2 4 , 271 with clinical indicators of MS. We found that the increased resolution of IEF compared to AGE enhanced our ability to make these correlations. Using IEF but not AGE, we found a correlation between higher band number and increased CSF IgG, IgG/albumin ratio, and CNS IgG synthesis.…”

The role of autoantibody and immune complexes in the pathogenesis of Guillain-Barre syndrome

“…Further, evidence of a hyperactive immune response is present in many patients with GBS. This is manifested by: Circulating immunoblasts in the blood which correlate with disease activity [ 1 I]; elevated levels of serum and cerebrospinal fluid (CSF) immunoglobulins of restricted electrophoretic heterogeneity that return toward normal with clinical improvement [12,15,34,38,391; autoantibodies to erythrocytes (cold agglutinins) [2 I]; and circulating antigen-antibody complexes [ 16,22,27,62,631. This collective evidence favors an immunological basis for demyelination in GBS, but does not enable one to distinguish between an autoimmune disorder and neural injury from an immune response to viral antigen that might be present in neural tissue.…”

Identification of peptides specific for cerebrospinal fluid antibodies in multiple sclerosis by using phage libraries.

“…The IgG patterns differ from one patient to another but remain fairly constant in each individual during the course of the disease (7-10) and do not appear to be affected by treatment with immunomodulatory drugs (11). These data seem to imply a specific immune response, developed within the CNS, against persistent epitopes.OB antibodies can also be found in other inflammatory neurological diseases such as tuberculous meningitis, neurosyphilis, progressive rubella panencephalitis, subacute sclerosing panencephalitis, and others (8,(12)(13)(14)(15)(16). In these pathologies, the majority of the oligoclonal IgG has been found to recognize the etiologic agent (17), whereas for MS there is no general consensus on the nature of the antigens that react with the oligoclonal antibodies present in the CSF (18-21).…”

“…OB antibodies can also be found in other inflammatory neurological diseases such as tuberculous meningitis, neurosyphilis, progressive rubella panencephalitis, subacute sclerosing panencephalitis, and others (8,(12)(13)(14)(15)(16). In these pathologies, the majority of the oligoclonal IgG has been found to recognize the etiologic agent (17), whereas for MS there is no general consensus on the nature of the antigens that react with the oligoclonal antibodies present in the CSF (18)(19)(20)(21).…”