Lundberg F, Li D Q, Falkenback D, Lea T, Siesjö P, Söderström S, Kudryk B J, Tegenfeldt J O, Nomura S, Ljungh A
Department of Infectious Diseases and Medical Microbiology, Lund University, Sweden.
J Neurosurg. 1999 Jan;90(1):101-8. doi: 10.3171/jns.1999.90.1.0101.
The pathogenesis of cerebrospinal fluid (CSF) shunt infection is characterized by staphylococcal adhesion to the polymeric surface of the shunt catheter. Proteins from the CSF--fibronectin, vitronectin, and fibrinogen--are adsorbed to the surface of the catheter immediately after insertion. These proteins can interfere with the biological systems of the host and mediate staphylococcal adhesion to the surface of the catheter. In the present study, the presence of fibronectin, vitronectin, and fibrinogen on CSF shunts and temporary ventricular drainage catheters is shown. The presence of fragments of fibrinogen is also examined.
The authors used the following methods: binding radiolabeled antibodies to the catheter surface, immunoblotting of catheter eluates, and scanning force microscopy of immunogold bound to the catheter surface. The immunoblot showed that vitronectin was adsorbed in its native form and that fibronectin was degraded into small fragments. Furthermore, the study demonstrated that the level of vitronectin in CSF increased in patients with an impaired CSF-blood barrier. To study complement activation, an antibody that recognizes the neoepitope of activated complement factor C9 was used. The presence of activated complement factor C9 was shown on both temporary catheters and shunts.
Activation of complement close to the surface of an inserted catheter could contribute to the pathogenesis of CSF shunt infection.
脑脊液（CSF）分流感染的发病机制以葡萄球菌黏附于分流导管的聚合物表面为特征。脑脊液中的蛋白质——纤连蛋白、玻连蛋白和纤维蛋白原——在导管插入后立即吸附于导管表面。这些蛋白质会干扰宿主的生物系统，并介导葡萄球菌黏附于导管表面。在本研究中，显示了脑脊液分流管和临时脑室引流导管上存在纤连蛋白、玻连蛋白和纤维蛋白原。还对纤维蛋白原片段的存在情况进行了检测。
作者采用了以下方法：将放射性标记抗体结合到导管表面、对导管洗脱液进行免疫印迹以及对结合在导管表面的免疫金进行扫描力显微镜检查。免疫印迹显示玻连蛋白以天然形式被吸附，而纤连蛋白被降解成小片段。此外，研究表明脑脊液血脑屏障受损的患者脑脊液中玻连蛋白水平升高。为研究补体激活情况，使用了一种识别活化补体因子C9新表位的抗体。在临时导管和分流管上均显示有活化补体因子C9存在。
插入导管表面附近补体的激活可能有助于脑脊液分流感染的发病机制。
