Braga F M, dos Reis-Filho J B, de Camargo-Lima J G
Arq Neuropsiquiatr. 1983 Sep;41(3):254-65. doi: 10.1590/s0004-282x1983000300006.
In normal conditions there is a concentration gradient of proteins along the neuraxis. From a low level in the ventricles, ranging from 5 to 15 mg/10C ml, to an intermediate level in the cisterna magna, the protein content reaches its highest level in the lumbar sac, 12 to 44 mg/100 ml. Several mechanisms were considered to elucidate the origin of this gradient but many investigators think that the progressive increase of the protein concentration is best explained by the transfer of proteins from serum to the cerebrospinal fluid due to the relatively raised permeability of blood-cerebrospinal fluid barrier in the spinal subarachnoid space. This paper presents a study of the protein concentrations in cisternal and lumbar cerebrospinal fluid samples of patients with neurocysticercosis in activity. The 11 patients of the first group had free subarachnoid space communication between the cisterna magna and the lumbar sac; the 6 patients of the second group had a complete block of the subarachnoid space between these two levels. In every cerebrospinal fluid specimen the quantitative complement fixation test for cysticercus was performed and the titer determined in order to make an assessment of the central nervous system humoral immune response. The analysis of the data of this investigation shows that the concentration gradient of proteins is evident in the cerebrospinal fluid of patients with patency of the spinal subarachnoid space, and the ratio of concentrations of protein contents in simultaneous cisternal and lumbar samples was similar to that one observed in normal individuals. This gradient is also detected when the intensity of the humoral immune response is determined by quantitative complement fixation test for cysticercus in simultaneous cisternal and lumbar specimens. After the onset of spinal subarachnoid block, the confront of the results of the tests in cerebrospinal fluid samples, obtained before and after the blockage, shows a large increase both in the total protein content as well as the intensity of the humoral immune response, in the lumbar level. The similar increases both in protein concentration and titer of cysticercus complement fixation test in the lumbar fluid, in comparison with the cisternal fluid, in patients with patent spinal subarachnoid space, and the large simultaneous and similar increases in both protein content and titer of the cysticercus complement fixation test in the lumbar fluid of patients with spinal subarachnoid block are in disagreement with the usual explanation of the origin mechanisms of the gradient.(ABSTRACT TRUNCATED AT 400 WORDS)
在正常情况下，沿神经轴存在蛋白质浓度梯度。从脑室中的低水平，范围为5至15毫克/100毫升，到小脑延髓池中的中等水平，蛋白质含量在腰池达到最高水平，为12至44毫克/100毫升。人们考虑了几种机制来阐明这种梯度的起源，但许多研究者认为，蛋白质浓度的逐渐增加最好的解释是由于脊髓蛛网膜下腔中血脑脊髓液屏障的通透性相对升高，蛋白质从血清转移到脑脊液中。本文介绍了对活动期神经囊尾蚴病患者小脑延髓池和腰池脑脊液样本中蛋白质浓度的研究。第一组的11名患者小脑延髓池和腰池之间的蛛网膜下腔自由相通；第二组的6名患者这两个水平之间的蛛网膜下腔完全阻塞。在每份脑脊液标本中进行囊尾蚴定量补体结合试验并测定滴度，以便评估中枢神经系统的体液免疫反应。对本研究数据的分析表明，在脊髓蛛网膜下腔通畅的患者脑脊液中蛋白质浓度梯度明显，同时采集的小脑延髓池和腰池样本中蛋白质含量的浓度比与正常个体中观察到的相似。当通过同时采集的小脑延髓池和腰池标本中的囊尾蚴定量补体结合试验来确定体液免疫反应强度时，也能检测到这种梯度。脊髓蛛网膜下腔阻塞后，比较阻塞前后采集的脑脊液样本检测结果，发现腰池水平的总蛋白质含量以及体液免疫反应强度均大幅增加。脊髓蛛网膜下腔通畅的患者，与小脑延髓池液相比，腰池液中蛋白质浓度和囊尾蚴补体结合试验滴度均有类似增加；脊髓蛛网膜下腔阻塞患者的腰池液中蛋白质含量和囊尾蚴补体结合试验滴度同时大幅且类似增加，这与对该梯度起源机制的通常解释不一致。（摘要截断于400字）
