Olsson J E, Link H, Müller R
J Neurol Sci. 1976 Feb;27(2):233-45. doi: 10.1016/0022-510x(76)90064-2.
Cerebrospinal fluid (CSF) and serum from 35 pairs of multiple sclerosis (MS) patients were analysed as regards mononuclear pleocytosis, concentrations of total protein, immunoglobulin G and A and beta-trace protein, and kappa:lambda ratios, as well as the serum/CSF ratios of IgG and albumin. The disability of the patients differed, whereas the age and the duration of the disease were similar in each pair. Similar analyses were also performed on CSF and serum from 72 patients, who were subdivided according to age at onset and severity of the disease. The highest mean values of the CSF-IgG and the lowest mean values of the serum/CSF IgG ratios were found in the more disabled patients. CSF immunoglobulin abnormalities were encountered more often and were more pronounced in the patients with the most malignant course of the disease, i.e., in those with severe disability after a short duration of the disease (less than 10 yr) and in severely disabled patients with an early age at onset of the disease(less than 25 yr). Contrarily, normal mean values of CSF-IgG concentrations and serum/CFS/IgG ratios were found in the groups of patients without disability after a duration of the disease of 10 years or more, and patients without disability and an early age at onset of the disease (less than 25 yr). The observations indicate that the immune response is most vigorous in disabled patients with a short duration or with an early age at onset of the disease. MS patients with a late age at onset (greater than 35 yr) showed a less pronouced immune response within the CNS, irrespective of the occurrence of disability. The most disabled patients also showed the most severe blood-brain barrier damage as manifested by high mean values of total protein in CSF and low serum/CSF albumin ratios. The patients with severe disability and a long duration of the disease (greater than 10 yr) had the highest content of beta-trace protein in the CSF, probably as a sign of destruction of brain matter.
对35对多发性硬化症（MS）患者的脑脊液（CSF）和血清进行了分析，检测了单核细胞增多、总蛋白、免疫球蛋白G和A以及β-微量蛋白的浓度、κ:λ比值，以及IgG和白蛋白的血清/脑脊液比值。患者的残疾程度不同，但每对患者的年龄和病程相似。还对72例患者的脑脊液和血清进行了类似分析，这些患者根据发病年龄和疾病严重程度进行了细分。在残疾程度较高的患者中，脑脊液IgG的平均值最高，血清/脑脊液IgG比值的平均值最低。脑脊液免疫球蛋白异常在疾病病程最凶险的患者中更常出现且更明显，即病程短（小于10年）且残疾严重的患者，以及发病年龄早（小于25岁）且残疾严重的患者。相反，病程10年或更长时间后无残疾的患者组，以及发病年龄早（小于25岁）且无残疾的患者组，脑脊液IgG浓度和血清/脑脊液IgG比值的平均值正常。这些观察结果表明，在病程短或发病年龄早的残疾患者中，免疫反应最为强烈。发病年龄晚（大于35岁）的MS患者，无论是否存在残疾，其中枢神经系统内的免疫反应都不太明显。残疾最严重的患者还表现出最严重的血脑屏障损伤，表现为脑脊液中总蛋白的平均值高和血清/脑脊液白蛋白比值低。疾病病程长（大于10年）且残疾严重的患者脑脊液中β-微量蛋白含量最高，这可能是脑实质破坏的迹象。
