Lolli F, Halawa I, Link H
Department of Neurology, Karolinska Institute, Huddinge University Hospital, Huddinge, Sweden.
Acta Neurol Scand. 1989 Sep;80(3):238-47. doi: 10.1111/j.1600-0404.1989.tb03869.x.
The intrathecal production (ITP) of the immunoglobulins (Ig) G, A, M and D was examined in untreated patients with multiple sclerosis (MS) and controls. Sensitive sandwich enzyme-linked immunosorbent assay systems were applied to the determination of IgA, IgM and IgD levels in the cerebrospinal fluid and plasma from a group of 61 consecutive MS patients (41 relapsing-remitting and 20 secondary chronic progressive MS). Age-related reference limits for all Ig variables were defined in a group of 57 patients with tension headache. ITP of IgG was demonstrated in 85% of the MS patients, ITP of IgA in 41%, of IgM in 44% and of IgD in 18%. Among 9 MS patients with normal IgG index, 3 displayed ITP of IgA, 3 of IgM and 1 of IgD. Plasma IgA was elevated in 20% and plasma IgM in 24% of the MS cases. No significant variation of Ig ITP was demonstrated in a different group of 27 untreated MS patients examined during exacerbation and remission. Among control patients with other inflammatory nervous system diseases, ITP of IgA, IgM and IgD was found more frequently, and of IgG in a smaller percentage compared with MS patients.
对未经治疗的多发性硬化症（MS）患者和对照组进行了脑脊液中免疫球蛋白（Ig）G、A、M和D鞘内生成（ITP）的检测。应用灵敏的夹心酶联免疫吸附测定系统测定了一组61例连续MS患者（41例复发缓解型和20例继发慢性进展型MS）脑脊液和血浆中的IgA、IgM和IgD水平。在一组57例紧张性头痛患者中确定了所有Ig变量的年龄相关参考范围。85%的MS患者存在IgG的ITP，41%存在IgA的ITP，44%存在IgM的ITP，18%存在IgD的ITP。在9例IgG指数正常的MS患者中，3例显示IgA的ITP，3例显示IgM的ITP，1例显示IgD的ITP。20%的MS病例血浆IgA升高，24%的MS病例血浆IgM升高。在另一组27例未经治疗的MS患者病情加重期和缓解期进行检查，未发现Ig ITP有显著变化。在患有其他炎症性神经系统疾病的对照患者中，与MS患者相比，IgA、IgM和IgD的ITP更为常见，而IgG的ITP比例较小。
