The diagnostic significance of antibody specificity indices in multiple sclerosis and herpes virus induced diseases of the nervous system

Springer Science and Business Media LLC - Tập 70 - Trang 28-37 - 1992
K. Felgenhauer1, H. Reiber1
1Klinik und Poliklinik für Neurologie der Georg-August-Universität, Göttingen, Germany

Tóm tắt

The antibody specificity index (ASI) indicates the cerebrospinal fluid (CSF)/serum difference of antibody amounts per weight unit IgG (normal < 1.5). It has proven to be the most sensitive inflammation parameter in CSF analysis so far, more sensitive than the Western blot, the “oligoclonal” response, and the empirical differentiation of CSF immunoglobulins. By this diagnostic criterion, several benign viral meningitis cases were found to be caused by the varicella/zoster virus. The diagnostic relevance of local zoster antibody synthesis was greatest in ganglionitis cases, e.g., in zoster oticus sine herpete (facial paresis) and acute radicular syndromes of the elderly. The diagnostic significance of the local immune response against measles, rubella, and zoster antigens (MRZ response) was ascertained further. Together with oligoclonal gamma-globulin fractionation, there is now only 1 out of 100 multiple sclerosis (MS) patients left who has been found to have a normal CSF.

Tài liệu tham khảo

Bamborschke S, Porr A, Huber M, Heiss WD (1990) Demonstration of herpes simplex virus DNA in CSF cells by in situ hybridization for early diagnosis of herpes encephalitis. J Neurol 237:73–76 Beuche W, Thomas RS, Felgenhauer K (1989) Demonstration of zoster virus antibodies in cerebrospinal fluid cells. J Neurol 236:26–28 Bos CA, Olding-Stenkvist E, Wilterdink JB, Schaefer AJ (1987) Detection of viral antigens in cerebrospinal fluid of patients with herpes simplex virus encephalitis. J Med Virol 21:169–178 Dennin RH, Herb E (1989) Immunological diagnosis in viral infections of the central nervous system: course of antibody titres against homo- and heterologous viruses. Med Microbiol Immunol Berlin 178:255–268 Dhib-Jalbut S, Lewis K, Bradburn E, McFarlin DE, McFarland HF (1990) Measles virus polypeptide-specific antibody profile in multiple sclerosis. Neurology 40:430–435 Doerries R, Liebert UG, terMeulen V (1988) Comparative analysis of virus-specific antibodies and immunoglobulins in serum and cerebrospinal fluid of subacute measles virusinduced encephalomyelitis (SAME) in rats and subacute sclerosing panencephalitis (SSPE). J Neuroimmunol 19:339–352 Echevarria JM, Martinez-Martin P, Tellez A, de Ory F, Rapun JL, Bernal A, Estevez E, Najera R (1987) Aseptic meningitis due to varicella-zoster virus: serum antibody levels and local synthesis of specific IgG, IgM and IgA. J Infect Dis 155:959–967 Felgenhauer K (1988) Liquordiagnostik. In: Thomas L (ed) Labor und Diagnose. Medizinische Verlagsgesellschaft Marburg, pp 1403–1423 Felgenhauer K, Ackermann R (1985) Early diagnosis and treatment of herpes simplex encephalitis. J Neurol 232:123–124 Felgenhauer K, Nekic M, Ackermann R (1982) The demonstration of locally synthesized herpes simplex IgG antibodies in CSF by a Sepharose 4B linked enzyme immunoassay. J Neuroimmunol 3:149–158 Felgenhauer K, Schädlich HJ, Nekic M, Ackermann R (1985) Cerebrospinal fluid virus antibodies: a diagnostic indicator for multiple sclerosis? J Neurol Sci 71:291–299 Forsberg P, Kam-Hansen S, Fryden A (1986) Production of specific antibodies by cerebrospinal fluid lymphocytes in patients with herpes zoster, mumps meningitis and herpes simplex virus encephalitis. Scand J Immunol 24:261–271 Hayashi K, Yanagi K, Takagi S (1986) Detection of herpes simplex virus type 1-IgM immune complexes in the brain of a patient with prolonged herpes encephalitis. J Infect Dis 153:56–63 Hyman RW, Ecker JR, Tenser RB (1983) Varicella-zoster virus RNA in human trigeminal ganglia. Lancet II:83 Johnson RT (1984) Viral infections of the nervous system. Raven Press, New York Kahlon J, Chatterjee S, Lakeman FD, Lee F, Nahmias AJ, Whitley RJ (1987) Detection of antibodies to herpes simplex virus in the cerebrospinal fluid of patients with herpes simplex encephalitis. J Infect Dis 155:38–44 Kennedy PGE (1987) Neurological complications of varicella-zoster virus. In: Kennedy PGE, Johnson RT (eds) Infections of the nervous system. Butterworths, London Laskin OL, Griffin DE (1987) Changes in cerebrospinal fluid cells, IgG and IgA during herpes simplex virus encephalitis in rabbits. J Neuroimmunol 14:283–292 Lüer W, Poser S, Weber T, Jürgens S, Eichenlaub D, Pohle HD, Felgenhauer K (1988) Chronic HIV encephalitis: I. Cerebrospinal fluid diagnosis. Klin Wochenschr 66:21 Mancardi GL, Melioli G, Traverso F, Tabaton M, Farinelli M, Terragna A (1987) Zoster sine herpete causing encephalomyelitis. Ital J Neurol Sci 8:67–70 Mathiesen T, Linde A, Olding-Stenkvist E, Wahren B (1989) Antiviral IgM and IgG subclasses in varicella zoster associated neurological syndromes. J Neurol Neurosurg Psychiatry 52:578–582 Mathiesen T, von Holst H, Fredrikson S, Wirsen G, Hederstedt B, Norrby E, Sundquist VA, Wahren B (1989) Total, anti-viral and anti-myelin IgG subclass reactivity in inflammatory diseases of the central nervous system. J Neurol 236:238–242 Mehta PD, Patrick BA, Sobczyk W, Kulczycki J, Woyciechowska-Camenga J, Camenga D, Thormar H (1989) Immunoglobulin G subclass antibodies to measles virus in patients with subacute sclerosing panencephalitis or multiple sclerosis. J Clin Microbiol 27:62–65 Neumann B, Ritter K, Felgenhauer K (1990) Fine specificities of antibodies in sera and cerebrospinal fluid in herpes virus infections of the central nervous system as detected by the antigen variable immunoblot technique. J Neuroimmunol 28:111–118 Prange HW, Moskophidis M, Schipper HI, Müller F (1983) Relationship between neurological features and intrathecal synthesis of IgG antibodies to treponema pallidum in untreated and treated human syphilis. J Neurol 230:241 Reiber H, Felgenhauer K (1987) Protein transfer at the blood cerebrospinal fluid barrier and the quantitation of the Immoral immune response within the central nervous system. Clin Chim Acta 163:319 Reiber H, Lange P (1991) Quantitation of virus-specific antibody concentrations in cerebrospinal fluid and serum: sensitive and specific detection of antibody synthesis in brain. Clin Chem (in press) Riikonen R, Meurman O (1989) Long-term persistence of intrathecal viral antibody responses in postinfectious diseases of central nervous system and in Rett syndrome. Neuropediatrics 20:215–219 Sharief MK, Thompson EJ (1990) A sensitive ELISA system for the rapid detection of virus specific IgM antibodies in the cerebrospinal fluid. J Immunol Methods 130:19–24 Stroop WG, McKendall RR, Battles EJ, Schaefer DC, Jones B (1990) Spread of herpes simplex virus type 1 in the central nervous system during experimentally reactivated encephalitis. Microb Pathog 8:119–134 van Loon AM, van der Logt JT, Heesen FW, Postma B, Peeters MF (1989) Diagnosis of herpes simplex virus encephalitis by detection of virus-specific immunoglobulins A and G in serum and cerebrospinal fluid by using an antibody-capture enzyme-linked immunosorbent assay. J Clin Microbiol 27:1983–1987 Vartdal F, Vandvik B, Norrby E (1982) Intrathecal synthesis of virus-specific oligoclonal IgG, IgA and IgM antibodies in a case of varicella zoster meningoencephalitis. J Neurol Sci 57:121–132 Wilske B, Schierz G, Preac-Mursic V, von Busch K, Kühlbeck R, Pfister HW, Einhüpel K (1986) Intrathecal production of specific antibodies against Borrelia burgdorferi in patients with lymphocytic meningoradiculitis (Bannwarth's syndrome). J Infect Dis 153:304–313