Cerebrospinal fluid C3 and C4 indexes in immunological disorders of the central nervous system.
OBJECTIVE
Validation of cerebrospinal fluid (CSF) indexes as a measure for intrathecal C3 and C4 production. Examination of their role in differential diagnosis of immunological disorders of the central nervous system (CNS).


METHODS
Correlative study in controls (low back pain without disk herniation) between the CSF/serum ratio (Q) for albumin, and Q C3 and Q C4. Comparative study of C3 and C4 indexes in patients with CNS dysfunction due to relapsing-remitting (RR) multiple sclerosis (MS), secondary progressive (SP) MS, systemic lupus erythematosus (SLE), and human immunodeficiency virus (HIV) infection.


RESULTS
Strong and statistically highly significant correlations between Q albumin and Q C3 (r=0.89, P=0.0001), and Q C4 (r=0.68, P= 0.0001). In MS patients decreased mean values for serum (RR, SP) and CSF (RR) C3, and increased C3 index mean value (RR, SP). In CNS SLE increase of mean C3 and C4 index values. In CNS HIV increase of mean C3 and C4 index values, and CSF C3 and C4 concentrations. Most individual index values were within the reference range.


CONCLUSIONS
CSF index is a valid tool to detect intrathecal C3 or C4 production. C3 or C4 index contributes little to the differential diagnosis of immunological CNS disorders. C3 might play a pathogenic role in various immunological CNS disorders.
Jongen
P J
PJ
Multiple Sclerosis Centre Nijmegen, The Netherlands.
Doesburg
W H
WH
Ibrahim-Stappers
J L
JL
Lemmens
W A
WA
Hommes
O R
OR
Lamers
K J
KJ
D015526:AIDS Dementia Complex / Q000097:blood / Q000134:cerebrospinal fluid* / Q000175:diagnosis; D000418:Albumins / Q000134:cerebrospinal fluid; D001327:Autoimmune Diseases; D001812:Blood-Brain Barrier; D016022:Case-Control Studies; D003176:Complement C3 / Q000134:cerebrospinal fluid*; D003181:Complement C4 / Q000134:cerebrospinal fluid*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000134:cerebrospinal fluid* / Q000175:diagnosis; D008297:Male; D020528:Multiple Sclerosis, Chronic Progressive / Q000097:blood / Q000134:cerebrospinal fluid* / Q000175:diagnosis; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000097:blood / Q000134:cerebrospinal fluid* / Q000175:diagnosis; D012016:Reference Values; D012709:Serum Albumin / Q000032:analysis; D018709:Statistics, Nonparametric
D000418:Albumins; D003176:Complement C3; D003181:Complement C4; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D012709:Serum Albumin