Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1985 Aug;48(8):807–813. doi: 10.1136/jnnp.48.8.807

Cerebrospinal fluid immunoglobulin abnormalities in systemic lupus erythematosus.

J Ernerudh, T Olsson, F Lindström, T Skogh
PMCID: PMC1028453  PMID: 3875690

Abstract

Central nervous system (CNS) involvement is a common and important complication in systemic lupus erythematosus. The mechanisms for CNS involvement are poorly understood and reliable diagnostic procedures are lacking. Pairs of serum and cerebrospinal fluid (CSF) specimens from 17 patients with clinical and serological manifestations of systemic lupus erythematosus were analysed. All 11 patients with definite or suspect clinical CNS disorder revealed some kind of abnormality in the CSF, in contrast to three of seven systemic lupus erythematosus patients without CNS disorder. The most prominent findings in systemic lupus erythematosus patients with CNS disorder were immune aberrations with oligoclonal bands on agarose isoelectric focusing (AIF) and elevation of IgG and IgM index, probably reflecting intrathecal production of IgG and IgM respectively. Intrathecal production of antiviral antibodies was found in four of 12 patients by AIF followed by immunofixation and subsequent autoradiography. An enzyme-linked immunoabsorbent assay (ELISA) could not detect autoantibodies against structural brain antigens.

Full text

PDF
812

Images in this article

810Image
on p.810

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brandt K. D., Lessell S. Migrainous phenomena in systemic lupus erythematosus. Arthritis Rheum. 1978 Jan-Feb;21(1):7–16. doi: 10.1002/art.1780210103. [DOI] [PubMed] [Google Scholar]
  2. Forsberg P., Henriksson A., Link H., Ohman S. Reference values for CSF-IgM, CSF-IgM/S-IgM ratio and IgM index, and its application to patients with multiple sclerosis and aseptic meningoencephalitis. Scand J Clin Lab Invest. 1984 Feb;44(1):7–12. doi: 10.3109/00365518409083780. [DOI] [PubMed] [Google Scholar]
  3. Glynn P., Gilbert H., Newcombe J., Cuzner M. L. Rapid analysis of immunoglobulin isoelectric focusing patterns with cellulose nitrate sheets and immunoperoxidase staining. J Immunol Methods. 1982 Jun 11;51(2):251–257. doi: 10.1016/0022-1759(82)90264-2. [DOI] [PubMed] [Google Scholar]
  4. Grigor R., Edmonds J., Lewkonia R., Bresnihan B., Hughes G. R. Systemic lupus erythematosus. A prospective analysis. Ann Rheum Dis. 1978 Apr;37(2):121–128. doi: 10.1136/ard.37.2.121. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Kadlubowski M., Hughes R. A., Gregson N. A. Experimental allergic neuritis in the Lewis rat: characterization of the activity of peripheral myelin and its major basic protein,P2. Brain Res. 1980 Feb 24;184(2):439–454. doi: 10.1016/0006-8993(80)90811-2. [DOI] [PubMed] [Google Scholar]
  6. Link H., Kam-Hansen S., Forsberg P., Henriksson A. Humoral and cellular immunity in patients with acute aseptic meningitis. Prog Brain Res. 1983;59:29–46. doi: 10.1016/S0079-6123(08)63849-2. [DOI] [PubMed] [Google Scholar]
  7. Link H., Kostulas V. Utility of isoelectric focusing of cerebrospinal fluid and serum on agarose evaluated for neurological patients. Clin Chem. 1983 May;29(5):810–815. [PubMed] [Google Scholar]
  8. Link H., Müller R. Immunoglobulins in multiple sclerosis and infections of the nervous system. Arch Neurol. 1971 Oct;25(4):326–344. doi: 10.1001/archneur.1971.00490040052007. [DOI] [PubMed] [Google Scholar]
  9. Link H., Tibbling G. Principles of albumin and IgG analyses in neurological disorders. III. Evaluation of IgG synthesis within the central nervous system in multiple sclerosis. Scand J Clin Lab Invest. 1977 Sep;37(5):397–401. doi: 10.1080/00365517709091498. [DOI] [PubMed] [Google Scholar]
  10. Nordal H. J., Vandvik B., Norrby E. Multiple sclerosis: local synthesis of electrophoretically restricted measles, rubella, mumps and herpes simplex virus antibodies in the central nervous system. Scand J Immunol. 1978;7(6):473–479. doi: 10.1111/j.1365-3083.1978.tb00480.x. [DOI] [PubMed] [Google Scholar]
  11. Norton W. T., Poduslo S. E. Myelination in rat brain: changes in myelin composition during brain maturation. J Neurochem. 1973 Oct;21(4):759–773. doi: 10.1111/j.1471-4159.1973.tb07520.x. [DOI] [PubMed] [Google Scholar]
  12. Olsson T., Henriksson A., Link H., Kristensson K. IgM and IgG responses during chronic relapsing experimental allergic encephalomyelitis (r-EAE). J Neuroimmunol. 1984 Jul;6(4):265–281. doi: 10.1016/0165-5728(84)90013-4. [DOI] [PubMed] [Google Scholar]
  13. Olsson T., Kostulas V., Link H. Improved detection of oligoclonal IgG in cerebrospinal fluid by isoelectric focusing in agarose, double-antibody peroxidase labeling, and avidin-biotin amplification. Clin Chem. 1984 Jul;30(7):1246–1249. [PubMed] [Google Scholar]
  14. Roström B., Link H., Laurenzi M. A., Kam-Hansen S., Norrby E., Wahren B. Viral antibody activity of oligoclonal and polyclonal immunoglobulins synthesized within the central nervous system in multiple sclerosis. Ann Neurol. 1981 Jun;9(6):569–574. doi: 10.1002/ana.410090610. [DOI] [PubMed] [Google Scholar]
  15. Salmi A., Reunanen M., Ilonen J., Panelius M. Intrathecal antibody synthesis to virus antigens in multiple sclerosis. Clin Exp Immunol. 1983 May;52(2):241–249. [PMC free article] [PubMed] [Google Scholar]
  16. Seibold J. R., Buckingham R. B., Medsger T. A., Jr, Kelly R. H. Cerebrospinal fluid immune complexes in systemic lupus erythematosus involving the central nervous system. Semin Arthritis Rheum. 1982 Aug;12(1):68–76. doi: 10.1016/0049-0172(82)90024-5. [DOI] [PubMed] [Google Scholar]
  17. Sharp G. C., Irvin W. S., Tan E. M., Gould R. G., Holman H. R. Mixed connective tissue disease--an apparently distinct rheumatic disease syndrome associated with a specific antibody to an extractable nuclear antigen (ENA). Am J Med. 1972 Feb;52(2):148–159. doi: 10.1016/0002-9343(72)90064-2. [DOI] [PubMed] [Google Scholar]
  18. Shorr J., Roström B., Link H. Antibodies to viral and non-viral antigens in subacute sclerosing panencephalitis and multiple sclerosis demonstrated by thin-layer polyacrylamide gel isoelectric focusing, antigen immunofixation and autoradiography. J Neurol Sci. 1981 Jan;49(1):99–108. doi: 10.1016/0022-510x(81)90192-1. [DOI] [PubMed] [Google Scholar]
  19. Sindic C. J., Cambiaso C. L., Depré A., Laterre E. C., Masson P. L. The concentration of IgM in the cerebrospinal fluid of neurological patients. J Neurol Sci. 1982 Sep;55(3):339–350. doi: 10.1016/0022-510x(82)90131-9. [DOI] [PubMed] [Google Scholar]
  20. Tan E. M., Cohen A. S., Fries J. F., Masi A. T., McShane D. J., Rothfield N. F., Schaller J. G., Talal N., Winchester R. J. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1982 Nov;25(11):1271–1277. doi: 10.1002/art.1780251101. [DOI] [PubMed] [Google Scholar]
  21. Thompson E. J., Kaufmann P., Shortman R. C., Rudge P., McDonald W. I. Oligoclonal immunoglobulins and plasma cells in spinal fluid of patients with multiple sclerosis. Br Med J. 1979 Jan 6;1(6155):16–17. doi: 10.1136/bmj.1.6155.16. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Winfield J. B., Shaw M., Silverman L. M., Eisenberg R. A., Wilson H. A., 3rd, Koffler D. Intrathecal IgG synthesis and blood-brain barrier impairment in patients with systemic lupus erythematosus and central nervous system dysfunction. Am J Med. 1983 May;74(5):837–844. doi: 10.1016/0002-9343(83)91075-6. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES