Protein transfer at the blood cerebrospinal fluid barrier and the quantitation of the humoral immune response within the central nervous system

Reiber, Hansotto; Felgenhauer, K.

doi:10.1016/0009-8981(87)90250-6

Cited by 440 publications

(271 citation statements)

References 12 publications

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“…These changes are induced by parasite antigens and usually are more apparent and more severe when affect the CSF space 6 . CSF helps establish the etiological diagnosis (anti-Taenia antibodies immunoproduction) and determine whether the process is active (presence of the syndrome and immunoproduction of non-specific IgGs) [7][8][9] . Regardeless clinical forms and neuroimaging findings, whether active or not, inflammatory changes proper to the CSF syndrome of NC can be detected and are diagnostic parameters 1,3,[10][11][12][13][14][15] .…”

Section: Neurocysticercosis (Nc) Results From Taenia Solium Larvae Lomentioning

confidence: 99%

IgG intrathecal synthesis and specific antibody index in patients with neurocysticercosis

Machado

Livramento

Vaz

et al. 2002

Arq. Neuro-Psiquiatr.

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-We analyzed cerebrospinal fluid (CSF) and blood serum from 55 patients with neurocysticercosis (NC) at different clinical stages. According to inflammatory activity in the CSF, three stages were identified: (1) reactive, when there was at least an increase in the number of cells; (2) weakly reactive, when significant alterations were found in the CSF, including an increase in gamma globulins, albeit without hypercytosis; (3) non-reactive, when there was neither hypercytosis nor increase in gamma globulins. Nineteen patients had the reactive form; 18 had the weakly reactive form; 18 displayed the non-reactive form.

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Section: Neurocysticercosis (Nc) Results From Taenia Solium Larvae Lomentioning

confidence: 99%

IgG intrathecal synthesis and specific antibody index in patients with neurocysticercosis

Machado

Livramento

Vaz

et al. 2002

Arq. Neuro-Psiquiatr.

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“…Selective increase in the C S F Ig G level has been observed consistendy in M S and it has become an impor tant laboratory test for confirmation o f the diagnosis (Poser et al, 1983). A selective C S F Ig G increase can be estab lished by using the Ig G Index (L in k and Tibbling, 1977), formulas for intrathecal produced Ig G (Reiber and Felgenhauer, 1987;Ohman et al, 1992) or by detection o f C S F restricted oligoclonal Ig G bands (W alk e r et al, 1983;Luxton et al, 1990).…”

Section: Introductionmentioning

confidence: 99%

Cerebrospinal fluid free kappa light chains versus IgG findings in neurological disorders: qualitative and quantitative measurements

Lamers

Jong

Jongen

et al. 1995

Journal of Neuroimmunology

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In this study free kappa light chains in cerebrospinal fluid (C SF) were determined both by an affinity mediated capillary blotting technique after isoelectric focusing (IE F ) in agarose gel and by a quantitative enzyme linked immunosorbent assay (E L IS A ). The free kappa results were compared with the IgG findings in 4 neurological patient groups with a distinct C SF IgG pattern: (1) C SF without oligoclonal IgG bands, (2) C SF with serum derived IgG bands, (3) C SF restricted IgG bands and (4) C SF restricted and serum derived IgG bands. Oligoclonal free kappa bands are nearly absent in CSF of groups 1 + 2, and present in 88% of group 3 and 84% of group 4 patients. We could also establish free kappa indices from specimens in the 4 groups in analogy to IgG indices. Group 1 had a median free kappa index of 1.1, group 2: 1.0 and groups 3+ 4: 10.0. The correspondence between immunoblot and index findings for free kappa is better than for IgG. Free kappa index is more sensitive but somewhat less specific than IgG index for establishing intrathecal immune production.

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“…A comprehensive theoretical analysis of the diffusion law from blood to CSF was proposed by Reiber et al 10, 11. who provided an elegant mathematical formulation now widely used to quantify absolute and proportional ITS, a criterion used as supportive evidence to diagnose autoimmune and infectious disorders.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, since Q Alb increases with age, the IgG index is thought to decrease mechanically without any change in ITS 9. In fact, data are best fitted by an empiric hyperbolic function (the “Reibergram”),10 whose constant parameters were later improved thanks to a large dataset of 4154 control patients (supposed to be) devoid of ITS 11. Basically, the notion of hyperbolic function of quotients is based on the concept of decreased CSF flow rate, with the dual effect of a decrease in CSF volume flow and an increase in time to protein transfer, and “dysfunction of the BCB” is equivalent to a reduced CSF flow rate.…”

Section: Introductionmentioning

confidence: 99%

Estimation of intrathecal IgG synthesis: simulation of the risk of underestimation

Bonnan

Gianoli-Guillerme

Courtade

et al. 2018

Ann Clin Transl Neurol

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ObjectiveThe low level of passively diffused IgG through the blood–brain barrier is sufficient to blur the estimation of intrathecal IgG synthesis (ITS). Therefore, this estimation requires a mathematical calculation derived from empirical laws, but the range of normal values in healthy controls is wide enough to prevent a precise calculation. This study investigated the precision of various methods of ITS estimations and their application to two clinical situations: plasma exchange and immune suppression targeting ITS.MethodsBased on a mathematical model of ITS, we constructed a population of healthy controls and applied a tunable ITS.ResultsWe demonstrate the following results: underestimation of ITS is common at individual level but true ITS is well fitted by cohorts; Q IgG increases after plasma exchange; IgG Loc calculation based on Qlim falsely increases when Q Alb decreases; the sample size required to demonstrate a decrease in ITS increases exponentially with larger Q Alb.InterpretationStudies evaluating changes in ITS level should be adjusted to Q Alb. Low amounts of ITS could be largely underestimated.

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Protein transfer at the blood cerebrospinal fluid barrier and the quantitation of the humoral immune response within the central nervous system

Cited by 440 publications

References 12 publications

IgG intrathecal synthesis and specific antibody index in patients with neurocysticercosis

IgG intrathecal synthesis and specific antibody index in patients with neurocysticercosis

Cerebrospinal fluid free kappa light chains versus IgG findings in neurological disorders: qualitative and quantitative measurements

Estimation of intrathecal IgG synthesis: simulation of the risk of underestimation

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