Sellebjerg F, Frederiksen J L
Neurologisk afdeling, Københavns Amts Sygehus i Gentofte.
Ugeskr Laeger. 1993 Feb 22;155(8):558-60.
Intrathecal synthesis of IgG was measured in 136 patients using agarose isoelectric focusing followed by immunoperoxidase staining for the detection of oligoclonal bands, and separate measurement of the IgG-index by immune electrophoresis. Oligoclonal bands were detected in 10/52 patients with other neurological diseases (OND). Five of these patients had possible multiple sclerosis (MS), and five had infections of the central nervous system. Oligoclonal bands were detected significantly more often in patients with clinically definite MS (24/26 patients (92%): p < 10(-9)) and in patients with acute optic neuritis, which is often an early manifestation of MS (34/58 patients (56%): p = 0.00005). An elevated IgG-index was detected in 15/25 MS-patients (60%), and in 13/56 patients with optic neuritis (20%). We conclude that isoelectric focusing is a valuable method for the detection of intrathecal production of IgG, and, especially in optic neuritis, has a higher sensitivity than the IgG-index. The method is recommended in the routine diagnosis of MS.
采用琼脂糖等电聚焦法,随后进行免疫过氧化物酶染色以检测寡克隆带,并通过免疫电泳单独测量IgG指数,对136例患者进行鞘内IgG合成检测。在10/52例患有其他神经系统疾病(OND)的患者中检测到寡克隆带。其中5例患者可能患有多发性硬化症(MS),5例患有中枢神经系统感染。在临床确诊的MS患者中(24/26例患者(92%):p < 10(-9))以及在急性视神经炎患者中(急性视神经炎通常是MS的早期表现,34/58例患者(56%):p = 0.00005),寡克隆带的检测频率明显更高。在15/25例MS患者(60%)和13/56例视神经炎患者(20%)中检测到IgG指数升高。我们得出结论,等电聚焦是检测鞘内IgG产生的一种有价值的方法,尤其是在视神经炎中,其敏感性高于IgG指数。该方法推荐用于MS的常规诊断。