Mathiesen T, Linde A, Olding-Stenkvist E, Wahren B
Department of Virology, National Bacteriological Laboratory, Stockholm, Sweden.
J Neurol. 1988 Sep;235(7):400-6. doi: 10.1007/BF00314481.
Serum and cerebrospinal fluid (CSF) samples from 19 patients with a previous diagnosis of herpes simplex virus encephalitis (HSVE), from 14 patients with a previous diagnosis of non HSVE encephalitis and from 21 healthy subjects were examined to detect IgG subclasses 1-4 reactive with herpes simplex virus (HSV), cytomegalovirus (CMV) and varicella zoster virus (VZV). Antibodies to HSV were detected in CSF and serum from the 14 HSVE-patients with a reactivated HSV infection and from 3 of the 5 patients with a primary HSV infection. The predominant subclass pattern was an early HSV-specific IgG1 rise, followed by IgG3 and, more seldom, IgG4; HSV IgG2 was rarely seen. In HSVE patients, HSV IgG3 was absent in early samples and usually appeared 10-20 days after onset of disease. In 14 out of 16 seropositive healthy controls, on the other hand, HSV IgG3 was present in the CSF. Rising VZV IgG levels in serum and CSF were found in 11 HSVE patients. Eight of them showed signs of intrathecal VZV IgG1 synthesis. The VZV IgG reactivity was restricted to IgG1 in 7 of these whereas the HSV IgG subclass response also included IgG3 or 4. The appearance of several HSV IgG subclasses appeared to serve as a marker of HSV infection in spite of the serological VZV reaction, usually restricted to VZV IgG1. Intrathecal synthesis of the quantitatively minor HSV IgG3 and 4 subclasses was detected earlier than intrathecal synthesis of total HSV IgG, dominated by IgG1 in 4 patients with HSVE.
对19例既往诊断为单纯疱疹病毒性脑炎（HSVE）的患者、14例既往诊断为非HSVE脑炎的患者以及21名健康受试者的血清和脑脊液（CSF）样本进行检测，以检测与单纯疱疹病毒（HSV）、巨细胞病毒（CMV）和水痘带状疱疹病毒（VZV）反应的IgG亚类1 - 4。在14例HSV再激活感染的HSVE患者以及5例原发性HSV感染患者中的3例的脑脊液和血清中检测到了抗HSV抗体。主要的亚类模式是早期HSV特异性IgG1升高，随后是IgG3，较少见的是IgG4；很少见到HSV IgG2。在HSVE患者中，早期样本中不存在HSV IgG3，通常在疾病发作后10 - 20天出现。另一方面，在16名血清阳性的健康对照者中的14例中，脑脊液中存在HSV IgG3。在11例HSVE患者中发现血清和脑脊液中VZV IgG水平升高。其中8例显示有鞘内VZV IgG1合成的迹象。其中7例的VZV IgG反应仅限于IgG1，而HSV IgG亚类反应还包括IgG3或4。尽管存在血清学VZV反应（通常仅限于VZV IgG1），但几种HSV IgG亚类的出现似乎可作为HSV感染的标志物。在4例HSVE患者中，鞘内合成的数量较少的HSV IgG3和4亚类比以IgG1为主的总HSV IgG的鞘内合成更早被检测到。
