Prüss Harald, Iggena Deetje, Baldinger Tina, Prinz Vincent, Meisel Andreas, Endres Matthias, Dirnagl Ulrich, Schwab Jan M
Department of Neurology, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
Arch Neurol. 2012 Jun;69(6):714-7. doi: 10.1001/archneurol.2011.3252.
Immune mechanisms are included in stroke pathophysiologic factors, but the frequency and role of intrathecal antibodies is unclear and diagnostic tests are not routinely performed on cerebrospinal fluid (CSF).
To determine the frequency of intrathecal immunoglobulin synthesis in a well-characterized cohort of patients who experienced “noninflammatory”acute stroke.
Retrospective cohort study.
University hospital neurology department.
Patients (n=318) with stroke who were undergoing lumbar puncture during diagnostic workup and 79 control patients.
Cerebrospinal fluid–specific immunoglobulin(IgG, IgM, and IgA) synthesis was significantly(P.001) more frequent after stroke (24.8%) compared with the incidence in age- and sex-matched controls(2.5%). Furthermore, 31.3% of stroke patients demonstrated blood-brain barrier dysfunction and 18.1% displayed pleocytosis.
The strong association between CSF-specific immunoglobulin synthesis and stroke suggests a role in the development of cerebral ischemia and might constitute an immunologically defined stroke subgroup.
免疫机制包含在中风的病理生理因素中，但鞘内抗体的频率和作用尚不清楚，且脑脊液（CSF）的诊断测试并非常规进行。
确定在经历“非炎症性”急性中风的特征明确的患者队列中鞘内免疫球蛋白合成的频率。
回顾性队列研究。
大学医院神经内科。
在诊断检查期间接受腰椎穿刺的中风患者（n = 318）和79名对照患者。
与年龄和性别匹配的对照组（2.5%）相比，中风后脑脊液特异性免疫球蛋白（IgG、IgM和IgA）合成显著更频繁（P <.001）（24.8%）。此外，31.3%的中风患者表现出血脑屏障功能障碍，18.1%出现细胞增多。
脑脊液特异性免疫球蛋白合成与中风之间的密切关联表明其在脑缺血发展中起作用，可能构成一个免疫定义的中风亚组。
