Abstract
The humoral immune response to treatment with praziquantel (PZQ) was studied in eight patients with parenchymal cerebral cysticercosis (CC). In the serum and in the cerebrospinal fluid (CSF) before, during and after the administration of the drug, the following were quantitated (a) levels of specific anticysticercous antibodies measured in optical densities by the ELISA method; (b) levels of IgG, IgM, IgA and IgE; (c) levels of complement fraction C3, C4; (d) presence of immune complexes; (e) total number of white blood cells in the CSF. It was found that after treatment with PZQ, the level of specific anticysticercous antibodies and the level of IgG rose significantly in the CSF but not in the blood. The levels of the fractions of the complement and the immunoglobulins IgM, IgA and IgE did not change significantly either in the serum or in the CSF. The blood-brain barrier was found ruptured in three patients before therapy and in five patients after the therapy as measured by the albumin index. Nevertheless, the IgG index showed that there was local production of IgG in five patients before treatment and in seven after the end of it. The relative specific antibody index was greater than 1.0 in five patients before therapy and in seven after therapy. This data strongly supports the idea that the specific antibodies are produced intrathecally and are not derived from the serum pool through a ruptured blood-brain barrier. It was concluded that patients with parenchymal CC have an elevation of specific anticysticercous probably due to a combination of a ruptured blood-brain barrier and intrathecal synthesis. The relatively small rupture of the blood-brain barrier and the high IgG and relative specific antibody index suggest that intrathecal synthesis is the most important mechanism. The humoral immune response may be of importance not only in the elimination of the parasite but also in the genesis of the illness.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Botero D., Castaño S. Treatment of cysticercosis with praziquantel in Colombia. Am J Trop Med Hyg. 1982 Jul;31(4):811–821. doi: 10.4269/ajtmh.1982.31.811. [DOI] [PubMed] [Google Scholar]
- Corona T., Pascoe D., González-Barranco D., Abad P., Landa L., Estañol B. Anticysticercous antibodies in serum and cerebrospinal fluid in patients with cerebral cysticercosis. J Neurol Neurosurg Psychiatry. 1986 Sep;49(9):1044–1049. doi: 10.1136/jnnp.49.9.1044. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Felgenhauer K., Nekic M., Ackermann R. The demonstration of locally synthesized herpes simplex IgG antibodies in CSF by a Sepharose 4B linked enzyme immunoassay. J Neuroimmunol. 1982 Oct;3(2):149–158. doi: 10.1016/0165-5728(82)90048-0. [DOI] [PubMed] [Google Scholar]
- Flisser A. Immunología de la cisticercosis humana. Bol Estud Med Biol. 1983 Jul-Oct;32(7-8):143–176. [PubMed] [Google Scholar]
- Johnson R. T., Griffin D. E., Hirsch R. L., Wolinsky J. S., Roedenbeck S., Lindo de Soriano I., Vaisberg A. Measles encephalomyelitis--clinical and immunologic studies. N Engl J Med. 1984 Jan 19;310(3):137–141. doi: 10.1056/NEJM198401193100301. [DOI] [PubMed] [Google Scholar]
- Lefvert A. K., Link H. IgG production within the central nervous system: a critical review of proposed formulae. Ann Neurol. 1985 Jan;17(1):13–20. doi: 10.1002/ana.410170105. [DOI] [PubMed] [Google Scholar]
- Lombardo L., Vasconcelos D., Cruz-Segura H. Tratamiento de la cisticercosis con prazicuantel. Informe preliminar de diez casos. Gac Med Mex. 1983 Jan;119(1):17–22. [PubMed] [Google Scholar]
- Sotelo J., Escobedo F., Rodriguez-Carbajal J., Torres B., Rubio-Donnadieu F. Therapy of parenchymal brain cysticercosis with praziquantel. N Engl J Med. 1984 Apr 19;310(16):1001–1007. doi: 10.1056/NEJM198404193101601. [DOI] [PubMed] [Google Scholar]
- Tourtellotte W. W., Potvin A. R., Fleming J. O., Murthy K. N., Levy J., Syndulko K., Potvin J. H. Multiple sclerosis: measurement and validation of central nervous system IgG synthesis rate. Neurology. 1980 Mar;30(3):240–244. doi: 10.1212/wnl.30.3.240. [DOI] [PubMed] [Google Scholar]