Elovaara I, Seppälä I, Palo J, Sulkava R, Erkinjuntti T
Department of Neurology, University of Helsinki, Finland.
Acta Neurol Scand. 1988 May;77(5):397-401. doi: 10.1111/j.1600-0404.1988.tb05925.x.
We examined serum and cerebrospinal fluid (CSF) of 16 patients with Alzheimer's disease (AD), 28 patients with vascular dementia (VD), their age-matched controls and multiple sclerosis (MS) patients in order to evaluate the humoral immune response within the central nervous system both quantitatively and qualitatively. Intra-blood-brain barrier (BBB) protein synthesis was calculated by CSF IgG index. The presence of oligoclonal banding (OCB) was investigated with agarose isoelectric focusing (IEF) followed by immunoblotting with antihuman IgG. No patient with AD and only 4 patients with VD had slightly elevated IgG indexes, and no statistically significant differences in the indexes were found between the two groups. No bands were found in the CSF of AD patients but 3 VD patients had OCB in both serum and CSF. One VD patient had bands in serum but no bands in CSF. No kappa or lambda free light chains were found in those demented patients with demonstrable bands in the CSF and serum. No OCB were found in control sera and CSF. For comparison, the majority of patients with MS had OCB in CSF. Thus, no consistent increase of intrathecal protein synthesis was found in patients with AD and VD. Methodological differences explain at least part of the conflicting results published earlier.
我们检测了16例阿尔茨海默病(AD)患者、28例血管性痴呆(VD)患者、与之年龄匹配的对照者以及多发性硬化症(MS)患者的血清和脑脊液(CSF),以便从定量和定性两方面评估中枢神经系统内的体液免疫反应。通过脑脊液IgG指数计算血脑屏障(BBB)内的蛋白质合成情况。采用琼脂糖等电聚焦(IEF),随后用抗人IgG进行免疫印迹,研究寡克隆带(OCB)的存在情况。AD患者中无一人、VD患者中仅有4人IgG指数略有升高,两组之间该指数无统计学显著差异。AD患者的脑脊液中未发现条带,但3例VD患者的血清和脑脊液中均有OCB。1例VD患者血清中有条带,但脑脊液中无条带。在脑脊液和血清中有可证实条带的痴呆患者中未发现κ或λ游离轻链。对照者的血清和脑脊液中未发现OCB。作为比较,大多数MS患者的脑脊液中有OCB。因此,未发现AD和VD患者鞘内蛋白质合成持续增加。方法学差异至少部分解释了早期发表的相互矛盾的结果。