T and B cell specific immune responses to purified protein derivative in the cerebrospinal cavity may be maintained and regulated independently of systemic immune control.
In vivo activated T cells could be isolated from cerebrospinal fluid (CSF) of a patient suffering from chronic meningitis of unclear origin. Although the patient's skin reactivity to purified protein derivative (PPD) was negative, and peripheral T cells did not proliferate to this antigen in vitro, the majority of T cell clones from CSF specifically recognized PPD on either autologous or allogeneic HLA class II compatible macrophages. Remarkably, peripheral blood mononuclear cells potently suppressed the PPD-specific proliferative responses of healthy donors. The selective enrichment of oligoclonal IgG in the CSF but not in the patient's serum further indicated T and B cell responses lacking systemic feedback control. Analyses of a persisting immune stimulation in the CSF provide a potent diagnostic tool and may explain neurological complications as observed in a number of autoimmune diseases and chronic infections.
Schneider
E M
EM
Department of Internal Medicine, University of Tübingen, FRG.
von Zitzewitz
F
F
Meier
D
D
Zimmermann
C W
CW
Dichgans
J
J
Schlote
W
W
Wernet
P
P
D000328:Adult; D000938:Antigen-Presenting Cells / Q000276:immunology; D000945:Antigens, Differentiation, T-Lymphocyte / Q000032:analysis; D001402:B-Lymphocytes / Q000276:immunology*; D002555:Cerebrospinal Fluid / Q000276:immunology*; D002999:Clone Cells; D004306:Dose-Response Relationship, Immunologic; D005260:Female; D006681:HLA-D Antigens / Q000276:immunology; D006801:Humans; D008213:Lymphocyte Activation; D008214:Lymphocytes / Q000648:ultrastructure; D008854:Microscopy, Electron; D013601:T-Lymphocytes / Q000276:immunology*; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology; D014373:Tuberculin / Q000276:immunology*; D014390:Tuberculosis, Meningeal / Q000276:immunology*
D000945:Antigens, Differentiation, T-Lymphocyte; D006681:HLA-D Antigens; D014373:Tuberculin