Principles of albumin and IgG analyses in neurological disorders. I. Establishment of reference values

Abstract

Tibbling, G., Link, H. & Ohman, S. Principles of albumin and IgG analyses in neurological disorders. I. Establishment of reference values. Scand. J. din. Lab. Invest. 37, 385-390, 1977.Protein parameters in CSF and serum have been studied in ninety-three reference subjects. CSF/S albumin ratio is proposed to be superior to CSF-protein or CSF-albumin as a test of the blood-brain barrier function, while IgG-index = (CSF/S IgG ratio)/(CSF/S albumin ratio) is superior to CSF IgG/protein ratio or CSF/albumin ratio for the demonstration of IgG elevation in CSF due to synthesis within CNS. The two quotients recommended correct for variations of albumin and IgG concentrations in serum. When the serum proteins are within reference range, the CSF protein concentrations are mainly regulated by the permeability of the blood-brain barrier, while the influence of S-albumin and S-IgG is only secondarily. The CSF/S albumin ratio is age dependent, while IgG-index is not. A proposed graphical presentation of CSF/S albumin and IgG-index may facilitate the interpretation of these parameters in routine clinical work.

Elevated cerebrospinal fluid uric acid during relapse of neuromyelitis optica spectrum disorders

“…Cerebrospinal fluid and serum albumin were quantified to calculate the CSF Albumin Index (CSF AI) as a validated marker for BBB integrity (Tibbling, Link, & Ohman, 1977). Albumin in CSF and serum was measured by routine automated laser photometry and the CSF/serum albumin ratio (CSF AI) was used to evaluate BBB disturbance (BBB index).…”

Autoreactive T and B cells responding to myelin proteolipid protein in multiple sclerosis and controls

“…they were in all respects able to manage on their own, while the remaining nine patients had moderate or severe disability, implying dependence on assistance to various degrees as far as the patients' professional and social lives were concerned. Findings from routine studies of CSF included mononuclear pleocytosis (> 5 x l o(%) in 21 patients (@YO), damage of the blood-brain barrier as reflected by slightly elevated CSF/plasma albumin ratio [24] in 10 patients (23%), elevated (>0.7) IgG index [25] in 36 patients (84%), and oligoclonal IgG bands in CSF in all 43 patients as demonstrated when unconcentrated CSF and diluted plasma were examined by agarose isoelectric focusing followed by protein transfer to nitrocellulose membrane, immunoblot, avidin-biotin amplification and peroxidase staining [26].…”

Intra-blood-brain barrier synthesis of human immunodeficiency virus antigen and antibody in humans and chimpanzees.

“…In each of two HIV-Ag negative asymptomatic men, HIV-Ag was detected in complexed form in the serum and CSF, respectively, after dissociation with 6 M guanidine. (S) and CSF from patients with AIDS (7-12) and ARC (18), and from asymptomatic HIV-seropositive controls (20)(21)(22)(23). The patient numbers correspond to the numbers in Table 1.…”