Vaishnavi C, Dhand U K, Dhand R, Agnihotri N, Ganguly N K
Department of Experimental Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Hyg Epidemiol Microbiol Immunol. 1992;36(3):317-25.
Cerebrospinal fluid (CSF) samples were collected from 12 patients with pyogenic meningitis (PM), 19 with tuberculous meningitis (TBM), 20 with clinically suspected but not definitely proved cases of tuberculous meningitis (STBM) and 12 normal controls. C-reactive proteins, immunoglobulins G, A, M and mycobacterial antigens were estimated in the CSF samples. Seven out of 51 (13.7%) samples obtained from the patient groups were positive for CRP. Immunoglobulins M and A were significantly raised in the PM group. When the TBM and STBM groups were compared with the controls a highly significant increase was obtained for all immunoglobulins. Mycobacterial antigens/epitopes were identified in 36.8% samples with TBAGB1 and TB68-H monoclonals and in 26.3% with WTB72-A2. In case of patients with suspected TBM, 6.6% were positive with TBAGB1 and WTB72-A2 and 13.3% with TB68-H. However, non-tuberculous patients also reacted with WTB72-A2 (10.5%) and TB68-H (21.0%). This is, to the authors' knowledge, the first report on the presence of CRP in the CSF. Technique for immunoglobulins in CSF is also updated in this paper. We infer that the monoclonal antibody TBAGB1 and immunoglobulins G and A may be safely considered as diagnostic markers of TBM. Estimation of CRP in CSF samples may be made to give a preliminary or additional diagnosis of meningitis regardless of its aetiology.
从12例化脓性脑膜炎（PM）患者、19例结核性脑膜炎（TBM）患者、20例临床疑似但未确诊的结核性脑膜炎（STBM）患者以及12名正常对照者中采集脑脊液（CSF）样本。对CSF样本中的C反应蛋白、免疫球蛋白G、A、M以及结核分枝杆菌抗原进行了检测。从患者组获取的51份样本中有7份（13.7%）CRP呈阳性。PM组中免疫球蛋白M和A显著升高。将TBM组和STBM组与对照组进行比较时，所有免疫球蛋白均有极显著升高。使用TBAGB1和TB68 - H单克隆抗体在36.8%的样本中鉴定出结核分枝杆菌抗原/表位，使用WTB72 - A2在26.3%的样本中鉴定出结核分枝杆菌抗原/表位。在疑似TBM的患者中，6.6%的患者TBAGB1和WTB72 - A2呈阳性，13.3%的患者TB68 - H呈阳性。然而，非结核患者对WTB72 - A2（10.5%）和TB68 - H（21.0%）也有反应。据作者所知，这是关于CSF中存在CRP的首次报道。本文还更新了CSF中免疫球蛋白的检测技术。我们推断单克隆抗体TBAGB1以及免疫球蛋白G和A可安全地视为TBM的诊断标志物。对CSF样本进行CRP检测，无论脑膜炎的病因如何，都可为脑膜炎的初步诊断或辅助诊断提供依据。
