Herpes simplex virus encephalitis: intrathecal synthesis of oligoclonal virus-specific IgG, IgA and IgM antibodies.
ABSTRACT Paired specimens of serum and CSF from seven patients with acute herpes simplex virus encephalitis were examined during the acute illness or the convalescent stage or during both stages. Imprint immunofixation analyses of viral antibodies separated by agarose electrophoresis and by electrofocusing disclosed intrathecal production of herpes simplex virus IgG antibodies in all seven patients, and of IgA and IgM antibodies in six and three of six patients, respectively. Intrathecal production of herpes simplex virus-specific IgG and IgA was observed in two patients from whom samples were collected after 1 year, while intrathecal production of virus-specific IgM was not demonstrated later than 5 weeks after onset. The intrathecally synthesized IgG and IgM, and to a lesser extent IgA antibodies displayed oligoclonal characteristics. Oligoclonal bands of IgG were observed in the CSF of all patients. Evidence is presented to show that the bulk of the oligoclonal CSF IgG represents herpes simplex virus-specific antibodies. Intrathecally synthesized populations of herpes simplex virus antibodies cross-reacting with varicella-zoster virus were identified in three of the patients.
- Scandinavian Journal of Clinical and Laboratory Investigation 10/1977; 37(5):385-90. · 1.29 Impact Factor
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ABSTRACT: Cerebrospinal fluid (CSF) and serum from 19 patients with mumps meningitis and 19 patients with meningitis of other etiology were investigated on two or more occasions for at least 1 month after onset. Intrathecal synthesis of immunoglobulin (Ig) G was found in 55%, of IgA in 26%, and of IgM in 24% of the patients. Oligoclonal Ig was demonstrable by agarose gel electrophoresis in 37% of the patients, mostly already during the first week after onset, and could persist for years. Mumps virus antibody synthesis within the central nervous system occurred in 37% of the mumps meningitis patients. The inflammatory reaction within the central nervous system as reflected by mononuclear pleocytosis, Ig synthesis, and oligoclonal Ig was not correlated to the clinical course. The blood-brain barrier was evaluated by determination of the CSF total protein, CSF/serum albumin ratio, and CSF/serum alpha2-macroglobulin ratio. A significant correlation was found among these three parameters. Persistence of the elevated CSF/serum albumin ratio seems to influence prognosis, and this parameter is recommended for evaluation of the blood-brain barrier function.Infection and Immunity 10/1978; 21(3):852-61. · 4.07 Impact Factor
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ABSTRACT: Oligoclonal IgG was present in the cerebrospinal fluid (CSF) of each of three patients with neurosyphilis studied. Conventional serological tests disclosed reduced serum/CSF ratios of antibodies to Treponema pallidum (TP) in each patient, consistent with intrathecal production of treponemal antibodies. Antibody analyses of electrofocused specimens by an immunofixation technique disclosed intrathecal production of oligoclonal TP antibodies in all patients. Treponemal antibody light chains showed a close correlation with the light chains of the oligoclonal CSF IgG. Absorption of the CSF with TP caused removal of the oligoclonal IgG. The results provide strong evidence that the oligoclonal CSF IgG in neurosyphilis represents TP antibodies, reflecting a specific immune response in the central nervous system to the infectious agent.Annals of Neurology 02/1982; 11(1):35-40. · 11.19 Impact Factor