Intracranial synthesis of specific IgG antibody in cerebrospinal fluid of neurocysticercosis patients

, Cho, Seung Yull; , Kim, Suk Il; , Kang, Shin Yong; , Park, Ae Ja

doi:1988.26.1.15

Korean J Parasito > Volume 26(1):1988 > Article

Original Article


Korean J Parasitol. 1988 Mar;26(1):15-26. English. Published online Mar 20, 1994. http://dx.doi.org/10.3347/kjp.1988.26.1.15
Copyright © 1988 by The Korean Society for Parasitology


Intracranial synthesis of specific IgG antibody in cerebrospinal fluid of neurocysticercosis patients
Seung-Yull Cho,Suk Il Kim,Shin Yong Kang and Ae Ja Park^*
Department of Parasitology, College of Medicine, Chung-Ang University, Seoul 156-756, Korea.
^*Department of Clinical Pathology, College of Medicine, Chung-Ang University, Seoul 156-756, Korea.


Abstract
To determine the source of Cysticercus-specific IgG antibody in cerebro-spinal fluid(CSF), paired samples of serum and CSF were collected from confirmed neurocysticercosis, other neurologic diseases and normal control. The antibody levels in serum and CSF were measured by enzyme-linked immunosorbent assay (ELISA). With the measurement of total protein, albumin and IgG concentration in serum and CSF, the contribution of IgG in CSF were calculated in transudation, exudation and intracranial synthesis using the formula of Tourtellotte and Ma (1978). Mean concentrations of total protein, albumin, IgG and proportional IgG levels in CSF by transudation, exudation and intracranial synthesis were elevated in neurocysticercosis. But only the intracranial synthesis of IgG showed a statistically significant correlation with the specific IgG antibody levels in CSF. In CSF from lateral ventricle in the 4th ventricular neurocysticercosis, the protein concentrations were normal and the specific antibody levels were negative. However, in consecutively secured lumbar CSF from the same patients, the former were increased and the latter were positive. These results indicated that, in neurocysticercosis, the specific IgG antibody in CSF was a local product of intracranial synthesis.

Figures


	Fig. 1 Relationship between abs. of specific IgG antibody in CSF and claculated contribution of CSF IgG by transudation, exudation and intracranial synthesis. Closed circle (•): a neurocysticercosis patients of serum (+), open circle (◦): a patient of serum (-).

Tables


	Table 1 Results of Cysticercus-specific IgG antibody tests in serum and CSF by ELISA in subjected patients


	Table 2 Mean±SD of protein measurements, calculated contribution of IgG in CSF and abs. of specific IgG antibody in serum and CSF of the subjected patients


	Table 3 Relationship between total protein concentration and specific IgG antibody levels in CSF


	Table 4 Relationship between albumin concentration and specific IgG antibody levels in CSF


	Table 5 Relationship between IgG concentration and specific IgG antibody levels in CSF


	Table 6 Comparison of protein profiles and specific IgG antibody levels in 5 ventricular CSF and 3 paired lumbar CSF in nuerocysticercosis patients with the 4th ventricle lesions


	Table 7 Association of exudation with intracranial synthesis of IgG in CSF in neurocysticercosis patients

References


2.	Bradford MM. A rapid and sensitive method for the quantitation of microgram quantities of protein utilizing the principle of protein-dye binding. Anal Biochem 1976;72:248–254.

3.	Chang KH, Kim WS, Cho SY, Han MC, Kim CW. Comparative evaluation of brain CT and ELISA in the diagnosis of neurocysticercosis. AJNR Am J Neuroradiol 1988;9(1):125–130.

4.	Cho SY, Kim SI, Kang SY, Choi DY, Suk JS, Choi KS, Ha YS, Chung CS, Myung HJ. Evaluation of enzyme-linked immunosorbent assay in serological diagnosis of human neurocysticercosis using paired samples of serum and cerebrospinal fluid. Korean J Parasitol 1986;24(1):25–41.

5.	Choi BK, et al. Chung-Ang J Med 1986;11:135–146.

6.	Diwan AR, Coker-Vann M, Brown P, Subianto DB, Yolken R, Desowitz R, Escobar A, Gibbs CJ Jr, Gajdusek DC. Enzyme-linked immunosorbent assay (ELISA) for the detection of antibody to cysticerci of Taenia solium. Am J Trop Med Hyg 1982;31(2):364–369.

7.	Earnest MP, Reller LB, Filley CM, Grek AJ. Neurocysticercosis in the United States: 35 cases and a review. Rev Infect Dis 1987;9(5):961–979.

8.	Eckman I, Robbins JB, Van den, Lentz J, Scheinberg IH. Automation of a quantitative immunochemical microanalysis of human serum transferrin: a model system. Clin Chem 1970;16(7):558–561.

9.	Fahey JL, McKelvey EM. Quantitative determination of serum immunoglobulins in antibody-agar plates. J Immunol 1965;94:84–90.

*11.*	Griffin DE. Immunoglobulins in the cerebrospinal fluid: changes during acute viral encephalitis in mice. J Immunol 1981;126(1):27–31.

*12.*	Larralde C, Laclette JP, Owen CS, Madrazo I, Sandoval M, Bojalil R, Sciutto E, Contreras L, Arzate J, Diaz ML, et al. Reliable serology of Taenia solium cysticercosis with antigens from cyst vesicular fluid: ELISA and hemagglutination tests. Am J Trop Med Hyg 1986;35(5):965–973.

*13.*	Leibowitz S, Kennedy L. Cerebral vascular permeability and cellular infiltration in experimental allergic encephalomyelitis. Immunology 1972;22(5):859–869.

*14.*	Link H, Tibbling G. Principles of albumin and IgG analyses in neurological disorders. II. Relation of the concentration of the proteins in serum and cerebrospinal fluid. Scand J Clin Lab Invest 1977;37(5):391–396.

*15.*	Loo L, Braude A. Cerebral cysticercosis in San Diego. A report of 23 cases and a review of the literature. Medicine (Baltimore) 1982;61(6):341–359.

*16.*	McCormick GF, Zee CS, Heiden J. Cysticercosis cerebri. Review of 127 cases. Arch Neurol 1982;39(9):534–539.

*17.*	Miller B, Goldberg MA, Heiner D, Myers A, Goldberg A. A new immunologic test for CNS cysticercosis. Neurology 1984;34(5):695–697.

*18.*	Miller BL, Staugaitis SM, Tourtellotte WW, Shapshak P, Goldberg M, Heiner D, Weil M. Intra-blood-brain barrier IgG synthesis in cerebral cysticercosis. Arch Neurol 1985;42(8):782–784.

*19.*	Mohammad IN, Heiner DC, Miller BL, Goldberg MA, Kagan IG. Enzyme-linked immunosorbent assay for the diagnosis of cerebral cysticercosis. J Clin Microbiol 1984;20(4):775–779.

*20.*	Nash TE, Neva FA. Recent advances in the diagnosis and treatment of cerebral cysticercosis. N Engl J Med 1984;311(23):1492–1496.

*21.*	Nerenberg ST, Prasad R, Rothman ME. Cerebrospinal fluid IgG, IgA, IgM, IgD, and IgE levels in central nervous system disorders. Neurology 1978;28(10):988–990.

*22.*	Nieto D. Cysticercosis of the nervous system; diagnosis by means of the spinal fluid complement fixation test. Neurology 1956;6(10):725–738.

*23.*	Sotelo J, Guerrero V, Rubio F. Neurocysticercosis: a new classification based on active and inactive forms. A study of 753 cases. Arch Intern Med 1985;145(3):442–445.

*24.*	Spina-França A, Livramento JA, Bacheschi LA, Garcia-Lopes P. Cerebrospinal fluid immunoglobulins in cysticercosis of the central nervous system. Arq Neuropsiquiatr 1976;34(1):40–45.

*25.*	Stepien L. Cerebral cysticercosis in Poland. Clinical symptoms and operative results in 132 cases. J Neurosurg 1962;19:505–513.

*26.*	Tourtellotte WW, Ma BI. Multiple sclerosis: the blood-brain-barrier and the measurement of de novo central nervous system IgG synthesis. Neurology 1978;28(9 Pt 2):76–83.