title: Trans-blood-brain-barrier albumin leakage and comparisons of intrathecal IgG synthesis calculations in multiple sclerosis patients. Multiple Sclerosis Study Group, Alpha Interferon Study Group, and Azathioprine Study Group.
abstract: We compared four equations for estimating intrathecal IgG synthesis (Tibbling and Link IgG index (T/L), Schuller and Sagar (S/S), Reiber and Felgenhauer (R/F), and Tourtellotte (T) equations) using data from chronic progressive MS patients. For normal albumin leakage (AL) (< 75 mg/day-intact BBB), T (r = 0.15) and R/F (r = 0.10) showed comparable positive correlations with trans-BBB AL, T/L (r = -0.10) was negative and S/S was uncorrelated (r = 0.05). For abnormal AL (> or = 75 mg/day), the R/F (r = -0.24), S/S (r = -0.37) and the T/L (r = -0.22) equations overcorrected, whereas the T (r = 0.07) equation values did not correlate with AL. The albumin index and trans-BBB albumin leakage rate formulae gave essentially identical estimates of BBB leakage (r = 0.99, P = 0.0001). We conclude that in chronic progressive MS patients the R/F, T/L and S/S formulae overcompensate for large abnormal T-BBB albumin leakage rates. The T formula corrected best for IgG transudate at high AL rate values in MS.
authors.affiliation: Neurology Service, VAMC West Los Angeles 90073.
authors.forename: K
authors.initials: K
authors.lastname: Syndulko
authors.forename: W W
authors.initials: WW
authors.lastname: Tourtellotte
authors.forename: A J
authors.initials: AJ
authors.lastname: Conrad
authors.forename: G
authors.initials: G
authors.lastname: Izquierdo
mesh_terms: D000418:Albumins / Q000134:cerebrospinal fluid / Q000378:metabolism*; D000917:Antibody Formation; D001812:Blood-Brain Barrier; D001921:Brain / Q000276:immunology*; D002908:Chronic Disease; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid / Q000378:metabolism*; D009103:Multiple Sclerosis / Q000503:physiopathology*
chemical_list: D000418:Albumins; D007074:Immunoglobulin G