Abstract
Thin-layer polyacrylamide gel isoelectric focusing of cerebrospinal fluid (CSF) and serum obtained from one patient 48 and 65 days after the onset of tuberculous meningitis revealed five oligoclonal immunoglobulin zones in CSF without any counterpart in serum, indicating local immunoglobulin production. Subsequent immunofixation with specific antisera revealed that three of the zones consisted of immunoglobulin G lambda present simultaneously. Immunofixation with Mycobacterium tuberculosis and bacillus Calmette-Guérin (BCG) as antigens and autoradiography revealed zones of specific antibodies in the CSF which, regarding mobility, corresponded to oligoclonal and polyclonal CSF immunoglobulin G zones. No antibody activity was detectable in the corresponding serum, indicating that the antibodies present in CSF were synthesized within the central nervous system. In seven control patients (three with multiple sclerosis, four with chronic inflammatory central nervous system diseases of unknown cause) with oligoclonal CSF immunoglobulin, no evidence for local production of antibodies against M. tuberculosis or BCG was detectable. Immunofixation with M. tuberculosis or BCG as antigens and autoradiography may prove to be a useful diagnostic complement to conventional techniques in patients with suspected tuberculous meningitis.
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- Frydén A., Link H. Predominance of oligoclonal IgG type lambda in CSF in aseptic meningitis. Arch Neurol. 1979 Aug;36(8):478–480. doi: 10.1001/archneur.1979.00500440048008. [DOI] [PubMed] [Google Scholar]
- Laurenzi M. A., Link H. Characterisation of the mobility on isoelectric focusing of individual proteins in CSF and serum by immunofixation. J Neurol Neurosurg Psychiatry. 1979 Apr;42(4):368–372. doi: 10.1136/jnnp.42.4.368. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Laurenzi M. A., Link H. Localization of the immunoglobulins G, A and M, beta-trace protein and gamma-trace protein on isoelectric focusing of serum and cerebrospinal fluid by immunofixation. Acta Neurol Scand. 1978 Sep;58(3):141–147. doi: 10.1111/j.1600-0404.1978.tb02873.x. [DOI] [PubMed] [Google Scholar]
- Laurenzi M. A., Mavra M., Kam-Hansen S., Link H. Oligoclonal IgG and free chains in multiple sclerosis demonstrated by thin-layer polyacrylamide gel isoelectric focusing and immunofixation. Ann Neurol. 1980 Sep;8(3):241–247. doi: 10.1002/ana.410080304. [DOI] [PubMed] [Google Scholar]
- Link H. Comparison of electrophoresis on agar gel and agarose gel in the evaluation of gamma-globulin abnormalities in cerebrospinal fluid and serum in multiple sclerosis. Clin Chim Acta. 1973 Jul 27;46(4):383–390. doi: 10.1016/0009-8981(73)90251-9. [DOI] [PubMed] [Google Scholar]
- 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]
- Link H., Panelius M., Salmi A. A. Immunoglobulins and measles antibodies in subacute sclerosing panencephalitis. Arch Neurol. 1973 Jan;28(1):23–30. doi: 10.1001/archneur.1973.00490190041004. [DOI] [PubMed] [Google Scholar]
- 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]
- Nordal H. J., Vandvik B., Norrby E. Demonstration of electrophoretically restricted virus-specific antibodies in serum and cerebrospinal fluid by imprint electroimmunofixation. Scand J Immunol. 1978;7(5):381–388. doi: 10.1111/j.1365-3083.1978.tb00468.x. [DOI] [PubMed] [Google Scholar]
- Tibbling G., Link H., Ohman S. Principles of albumin and IgG analyses in neurological disorders. I. Establishment of reference values. Scand J Clin Lab Invest. 1977 Sep;37(5):385–390. doi: 10.1080/00365517709091496. [DOI] [PubMed] [Google Scholar]
- Vandvik B., Norrby E. Oligoclonal IgG antibody response in the central nervous system to different measles virus antigens in subacute sclerosing panencephalitis. Proc Natl Acad Sci U S A. 1973 Apr;70(4):1060–1063. doi: 10.1073/pnas.70.4.1060. [DOI] [PMC free article] [PubMed] [Google Scholar]