Abstract:A introdução do conceito de imunoglobulinas abriu novo campo de pesquisas na avaliação das afecções do sistema nervoso central (SNC), com novas perspectivas para os estudos sobre o líquido cefalorraqueano (LCR) em diversas condições mórbidas, notadamente nos processos inflamatórios do SNC. Devido à alta incidência de afecções inflamatórias do SNC em nosso meio, devido a peculiaridades nutricionais locais e dada a miscigenação racial de nossa gente, importa estabelecer parâmetros de avaliação aplicáveis ao conc… Show more
“…Considerando as características obtidas para LCR e soro foram calculados os índices de globulinas gama e de síntese diaria de globulinas gama intra-BHE. Como grupo controle para a normalidade foi utilizado aquele estabelecido pela mesma metodologia e no mesmo laboratório por Livramento, constituído de 50 pessoas com cefaléia crônica apresentando exame físico geral, especial e neurológico normais, bem como eletrencefalograma, exame do LCR e proteinograma do soro dentro dos limites da normalidade (24,25). Os exames das amostras de LCR e de soro foram efetuados segundo as técnicas adotadas no Centro de Investigações em Neurologia da FMUSP (4,49).…”
The study is based on 371 cerebrospinal fluid (CSF) samples and 324 serum samples from 40 patients with neurocysticercosis (NC) submitted to treatment with praziquantel. The aim of the study is a critical evaluation on humoral immunity in CSF NC syndrome. The analysis of NC patients at diagnosis and in the follow-up period was performed considering three connected criteria: the clinical one, the CSF examination and the computed tomography. For the study of CSF and serum samples a systematization of collection was scheduled in relation to: diagnosis; period of treatment; follow-up. A total of 13 samples for each case for a follow-up period of two years was scheduled. For the study of humoral immunity a semiquantitative methodology was employed to verify the intra blood-brain barrier (BBB) gamma globulins synthesis. It was based upon electrophoretic profile data on CSF and serum proteins, and relations and indexes. Normal values were previously characterized in a normal control group. This group was formed by 50 patients with chronic headache who presented normal neurological examination, as well as, CSF-examination and serum proteinogram under the safety limits of normality. To verify intra BBB gamma globulins synthesis it was considered the gamma globulin content of the CSF and serum, the gamma globulins/prealbumin + albumin relationship, the Link and Tibbling index, the intra BBB gamma globulins synthesis of Tourtellotte and col., and the appearance of oligoclonal bands in the CSF. Confirmation of the disease was performed by immunological reactions for cysticercosis: complement fixation test in CSF and serum; immunofluorescent test and enzyme-linked immunosorbent assay (ELISA) in CSF. Interference factors in the CSF NC syndrome were analysed at first such as those related to: clinical aspects, time of disease, previous dependence on corticotherapy, ventricular derivation shunts, tomographic findings. It was shown that all of them produce several degrees of interference in the intensity of the CSF NC syndrome. Data on intra BBB gamma globulins synthesis were verified in 37 patients (92.5%). It occurred in a persistent pattern in 18 cases (45%) during all the study phases, and not showed changes that might be related to treatment. On the other hand, it was shown that analysis of the results must always be performed case by case due to large dispersion of events observed and the differences of behavior of data related to humoral immunity, when critically analysed during diagnosis, treatment period and in the follow-up.(ABSTRACT TRUNCATED AT 400 WORDS)
“…Considerando as características obtidas para LCR e soro foram calculados os índices de globulinas gama e de síntese diaria de globulinas gama intra-BHE. Como grupo controle para a normalidade foi utilizado aquele estabelecido pela mesma metodologia e no mesmo laboratório por Livramento, constituído de 50 pessoas com cefaléia crônica apresentando exame físico geral, especial e neurológico normais, bem como eletrencefalograma, exame do LCR e proteinograma do soro dentro dos limites da normalidade (24,25). Os exames das amostras de LCR e de soro foram efetuados segundo as técnicas adotadas no Centro de Investigações em Neurologia da FMUSP (4,49).…”
The study is based on 371 cerebrospinal fluid (CSF) samples and 324 serum samples from 40 patients with neurocysticercosis (NC) submitted to treatment with praziquantel. The aim of the study is a critical evaluation on humoral immunity in CSF NC syndrome. The analysis of NC patients at diagnosis and in the follow-up period was performed considering three connected criteria: the clinical one, the CSF examination and the computed tomography. For the study of CSF and serum samples a systematization of collection was scheduled in relation to: diagnosis; period of treatment; follow-up. A total of 13 samples for each case for a follow-up period of two years was scheduled. For the study of humoral immunity a semiquantitative methodology was employed to verify the intra blood-brain barrier (BBB) gamma globulins synthesis. It was based upon electrophoretic profile data on CSF and serum proteins, and relations and indexes. Normal values were previously characterized in a normal control group. This group was formed by 50 patients with chronic headache who presented normal neurological examination, as well as, CSF-examination and serum proteinogram under the safety limits of normality. To verify intra BBB gamma globulins synthesis it was considered the gamma globulin content of the CSF and serum, the gamma globulins/prealbumin + albumin relationship, the Link and Tibbling index, the intra BBB gamma globulins synthesis of Tourtellotte and col., and the appearance of oligoclonal bands in the CSF. Confirmation of the disease was performed by immunological reactions for cysticercosis: complement fixation test in CSF and serum; immunofluorescent test and enzyme-linked immunosorbent assay (ELISA) in CSF. Interference factors in the CSF NC syndrome were analysed at first such as those related to: clinical aspects, time of disease, previous dependence on corticotherapy, ventricular derivation shunts, tomographic findings. It was shown that all of them produce several degrees of interference in the intensity of the CSF NC syndrome. Data on intra BBB gamma globulins synthesis were verified in 37 patients (92.5%). It occurred in a persistent pattern in 18 cases (45%) during all the study phases, and not showed changes that might be related to treatment. On the other hand, it was shown that analysis of the results must always be performed case by case due to large dispersion of events observed and the differences of behavior of data related to humoral immunity, when critically analysed during diagnosis, treatment period and in the follow-up.(ABSTRACT TRUNCATED AT 400 WORDS)
“…Pela análise da tabela 11, nota-se que o valor percentual médio de IgG obtido na presente investigação, é inferior àquele obtido por Livramento 40 , que no entanto quantificou as proteínas totais por turbidimetria após precipitação das proteínas pelo ácido tricoloracético, método este que fornece valores mais baixos de proteínas que o método colorimétrico aqui utilizado 72. p 0 r outro lado, a média de IgG, expressa em percentagem, do LCR-SO, aqui observada foi superior àquelas registradas pelos autores estrangeiros, quem sabe devido à via de colheita de LCR por eles utilizada.…”
Section: Taxas Normais De Imuneglobulinas Do Lcr-so De Crianças -Confunclassified
“…A taxa percentual média de IgA aqui calculada é semelhante àquelas registradas pelos autores estrangeiros, embora seja bem menor que a obtida em nosso meio por Livramento 40 , levantando pois a dúvida se os altos valores relativos de IgA obtidos por este autor não seriam, ao menos em parte, função da metodologia aplicada na quantificação de proteínas totais, sendo a via de colheita do LCR fator menos atuante.…”
Section: Taxas Normais De Imuneglobulinas Do Lcr-so De Crianças -Confunclassified
The literature on quantitation of immunoglobulins in normal CSF and variations of these values related to race, sex and age was reviewed. Immunoglobulins (Ig) G, A and M of normal CSF (sub-occipital puncture) of 116, 78 and 45 patients respectively, were measured by radial immunodiffusion, in order to verify variations related to race, sex and age, as well as to establish their normal limits. The results allowed us to conclude that: a) there are no differences between races with respect to the levels of IgG, A and M; b) variations related to sex or age on the CFS immunoglobulins content in children (1 to 11 years old) are not found; c) the mean IgG (mg/100 ml) level in children is lower than in adults, although the mean IgG percentage concentration in children is not different from that found in adults; the normal range for CSF IgG in children is 0.21 to 2.93 mg/100 ml; d) the mean IgA content (mg/100 ml and % of the total protein) in children are lower than in adults and in physiological conditions do not exceed 0.15 mg/100 ml (0.7% of the total protein); e) there are no differences related to sex or age with respect to the CSF levels of immunoglobulins in adults; the normal range of IgG in adults is 0.51 to 4.00 mg/100 ml; in children and adults the normal limits for the relative values of IgG are 3 to 12%; IgA is found in the CFS of adults in a concentration up to 0.32 mg/100 ml (0.9%); f) IgM is found in both children's and adults' CSF at very low levels, not exceeding 0.2 mg/100 ml (0.25%). Comparison of the results obtained in this work with those found in some publications was carried out and is briefly discussed.
“…Para a determinação no soro mediante IDR foram utilizadas placas de procedência Behring: TRI-Partigen para IgG; LC-Partigen para IgA e IgM. Para a determinação por IDR das imunoglobulinas no LCR foram empregadas placas LC-Partigen, também de procedência Behring, segundo técnica adotada cm nosso meio (7,8). As determinações de imunoglobulinas no soro e LCR por nefelometria, foram realizadas no Laboratório Biociências Lavoisier por gentileza do Prof. Dr. Aron J. Diament segundo metodologia já descrita (5,6,14).…”
Immunoglobulins IgG, IgA and IgM were studied in serum and cerebrospinal fluid (CSF) samples from 36 newborn infants in the second day of life. According to parameters previously established in the same laboratory for normal newborn infants, serum proteins were normal in all samples and CSF composition was normal as to blood pigments, cells, total proteins and protein fractions in all samples. Immunoglobulins concentrations were determined by two methods: radial immunodiffusion (RID) and nephelometry. Concentrations found (mean +/- standard deviation) were as follows (mg/dl). Serum: through the RID method IgG 1346 +/- 299.1, IgM 10.4 +/- 2.26, IgA 1.1 +/- 1.06; through nephelometry IgG 1372 +/- 319.7, IgM 10.6 +/- 4.10, IgA 1.5 +/- 0.31. Cerebrospinal fluid: IgA and IgM were not detected by the methods employed; IgG was detected by both methods, and values were 11.1 +/- 2.52 by RID and 9.6 +/- 7.04 by nephelometry. IgG relations and IgG index were also evaluated; values of the IgG index (0.5 +/- 0.14) are emphasized. Considerations are made in order to point out data obtained as to characterize normal values for immunoglobulins in the cerebrospinal fluid of normal newborn infants.
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