title: Local synthesis of IgA in the cerebrospinal fluid of patients with neurological diseases.
abstract: To date qualitative studies of IgA in the cerebrospinal fluid in neurological disease, particularly multiple sclerosis, have been few and given mixed results. The aim of this study was to identify local synthesis of IgA by detection of clonal IgA bands, in a large cohort of patients with a variety of neurological disorders, using polyacrylamide gel electrophoresis, transfer of protein to nitrocellulose membranes and specific staining. Of 2,097 sequentially analysed patients with suspected neurological disease 54 (2.6%) had locally synthesised IgA; most notably, IgA was present in 39 of 291 (13%) patients with suspected multiple sclerosis. The latter group also had a significant excess of light-chain production, particularly free kappa, when compared to multiple sclerosis patients without local synthesis of IgA. Locally synthesised IgA was also demonstrated in inflammatory, infectious and autoimmune diseases of the central nervous system. This qualitative technique is simple and suitable for routine analysis of cerebrospinal fluid, and further qualitative studies of IgA may be useful in investigating the pathophysiology of certain neurological disorders.
authors.affiliation: Department of Neuroimmunology, Institute of Neurology, London, UK.
authors.forename: S M
authors.initials: SM
authors.lastname: Leary
authors.forename: B N
authors.initials: BN
authors.lastname: McLean
authors.forename: E J
authors.initials: EJ
authors.lastname: Thompson
mesh_terms: D001327:Autoimmune Diseases; D015415:Biomarkers / Q000032:analysis; D015331:Cohort Studies; D004591:Electrophoresis, Polyacrylamide Gel; D006801:Humans; D007070:Immunoglobulin A / Q000096:biosynthesis* / Q000134:cerebrospinal fluid; D007239:Infections; D009422:Nervous System Diseases / Q000134:cerebrospinal fluid / Q000276:immunology*; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D007070:Immunoglobulin A