Elsevier

Clinica Chimica Acta

Volume 163, Issue 3, 30 March 1987, Pages 319-328
Clinica Chimica Acta

Protein transfer at the blood cerebrospinal fluid barrier and the quantitation of the humoral immune response within the central nervous system

https://doi.org/10.1016/0009-8981(87)90250-6Get rights and content

Abstract

The cerebrospinal fluid (CSF)/serum concentration quotients of albumin and the immunoglobulins G, A and M have been determined for 396 patients with a normal blood CSF barrier function or a pure barrier impairment without a humoral immune response within the central nervous system. The ratios between the concentration quotients of the three immunoglobulins and that of albumin increase in a nonlinear fashion with progressive impairments of the blood CSF barrier, i.e. the molecular size dependent discrimination of the protein transfer (‘selectivity’) decreases. The upper reference values of the concentration quotients for the whole range of passive transfer comply with the hyperbolic function: Q(IgX) = abQ(Alb)2 + b2 − c with different constants ab, b2, c for IgG (0.8, 15 × 10−6, 1.8 × 10−3), IgA (0.72, 80 × 10−6, 5.1 × 10−3) and IgM (0.65, 150 × 10−6, 7.5 × 10−3). With these discriminatory functions the locally synthesized fractions IgX(loc) of IgG, IgA and IgM in CSF can be calculated by the general formula: IgX(loc) = [Q(IgX) −ab√Q(Alb)2 + b2 + c]. IgX(Ser).

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    Albumin in CSF was measured using immune turbidimetric analysis (Roche/Hitachi MODULAR P800 Albumin). According to a previous study,27 the ratio of CSF-to-plasma of albumin (QAlbumin) > 0.02 was defined as severe dysfunction of the BBB, between 0.01 and 0.02 was moderate dysfunction, between 0.007 and 0.01 was mild dysfunction, and < 0.007 was normal function. The QBNP and QNT-proBNP indices were calculated and defined as follows: QBNP = CSF BNP concentration and/or plasma BNP concentration; and QNT-proBNP = CSF NT-proBNP concentration and/or plasma NT-proBNP concentration.

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