Brey R L, Arroyo R, Boswell R N
Department of Medicine (Neurology), University of Texas Health Science Center, San Antonio 78284.
J Acquir Immune Defic Syndr (1988). 1991;4(4):435-41.
Both cerebrospinal fluid (CSF) immunologic abnormalities and serum anti-cardiolipin antibodies (aCL) have been reported in patients with HIV-1 infection. The antibody specificity of only a small amount of the total CSF IgG in these patients is known, and is directed against a variety of HIV-1 antigens. The specificity of the remaining CSF IgG is unknown. We report the results of the first study of CSF aCL in an HIV-1-infected population. We measured aCL IgG and IgM in the CSF of 21 HIV-1-infected patients without nervous system symptoms or AIDS, and in four HIV-1-negative controls. Twelve HIV-1-infected patients had an abnormal serum aCL value and CSF immunologic abnormalities and 9 HIV-1-infected patients had either abnormal serum aCL or CSF immunologic abnormalities but not both, or were normal in both regards. There was no difference between any HIV-1-infected patient and controls for CSF aCL IgM. Nine of 12 patients with an abnormal serum aCL and CSF immunologic abnormalities had CSF aCL IgG values that were at least 5 SD above normal control values, whereas none of the remaining patients had abnormal CSF aCL IgG values. All patients with abnormal CSF aCL IgG values had an intact blood-brain barrier as evidenced by an albumin index of less than 9, and all had nonreactive CSF VDRL tests. These data demonstrate that aCL IgG is produced intrathecally in some HIV-1-infected patients.
据报道，HIV-1感染患者存在脑脊液（CSF）免疫异常和血清抗心磷脂抗体（aCL）。这些患者中，仅少量脑脊液总IgG的抗体特异性已知，且针对多种HIV-1抗原。其余脑脊液IgG的特异性未知。我们报告了对HIV-1感染人群脑脊液aCL的首次研究结果。我们检测了21例无神经系统症状或艾滋病的HIV-1感染患者以及4例HIV-1阴性对照者脑脊液中的aCL IgG和IgM。12例HIV-1感染患者血清aCL值异常且脑脊液存在免疫异常，9例HIV-1感染患者血清aCL或脑脊液免疫异常但并非两者均异常，或两者均正常。HIV-1感染患者与对照者在脑脊液aCL IgM方面无差异。12例血清aCL异常且脑脊液免疫异常的患者中有9例脑脊液aCL IgG值至少高于正常对照值5个标准差，而其余患者均无脑脊液aCL IgG值异常。所有脑脊液aCL IgG值异常的患者血脑屏障均完整，白蛋白指数小于9可证明这一点，且所有患者脑脊液VDRL试验均无反应。这些数据表明，一些HIV-1感染患者鞘内产生了aCL IgG。
