Synthesis of immunoglobulin within the central nervous system in multiple sclerosis and other neurological diseases. Detection by analysis of CSF/serum IgG ratio.
This study included 49 patients with clinical multiple sclerosis (MS), 105 patients with other neurological diseases (OND), and 30 controls. It compared seven assays for CNS IgG synthesis with the oligoclonal banding (agarose electrophoresis) method. A newly developed assay which determined the differences between the measured and calculated CSF/serum IgG ratio (M-C value), using albumin as a reference protein, was particularly sensitive to the diagnosis of MS. In 40/46 (87%) of patients with MS, the M-C value was 0.001 or more, while oligoclonal banding was found in CSF of 38/49 (78%). In the 30 controls, the M-C value was invariably less than 0.001 and oligoclonal banding was not found. In patients with OND, 26/104 (25%) had an M-C value of 0.001 of greater while 11/105 (11%) had oligoclonal banding in CSF. The M-C value also offers a convenient means of quantifying CNS IgG synthesis during disease activity of treatment. It is concluded that the combined use of the oligoclonal banding method and the M-C value determination gives the greatest predictive value for the diagnosis of MS.
D000418:Albumins / Q000134:cerebrospinal fluid; D002490:Central Nervous System / Q000276:immunology*; D002493:Central Nervous System Diseases / Q000134:cerebrospinal fluid* / Q000276:immunology; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis; D004587:Electrophoresis, Agar Gel; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis / Q000096:biosynthesis* / Q000134:cerebrospinal fluid; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid* / Q000276:immunology
D000418:Albumins; D002556:Cerebrospinal Fluid Proteins; D007074:Immunoglobulin G