Abstract
Background and aims: Cerebrospinal fluid (CSF) protein content presents a sexual dimorphism in humans. We investigated sex-related differences in CSF IgG levels and in the quantification of intrathecal IgG synthesis (IIS). Methods: CSF, serum albumin and IgG were measured in 1519 neurological patients and both linear and hyperbolic formulas were used for the quantification of IIS. CSF-restricted oligoclonal IgG bands (OCBs) were used as “gold standard”. Results: The linear IgG Index showed a weak agreement with OCBs in males and females (k = 0.559, k = 0.587, respectively), while the hyperbolic Reiber’s formulas had a moderate agreement with OCBs in females (k = 0.635) and a weak agreement in males (k = 0.565). Higher CSF albumin and IgG levels were found in men than in women in the whole population and in subjects without IIS after adjusting for age and for serum concentrations of albumin and IgG, respectively (Quade statistics, p < 0.000001). CSF and serum albumin and IgG levels positively correlated to age in both sexes. CSF total protein content did not correlate with CSF leukocyte numbers but was higher in patients with marked pleocytosis. Conclusions: In neurological patients, men have higher levels of CSF serum-derived proteins, such as albumin and IgG.
Highlights
Cerebrospinal fluid (CSF) is a watery body fluid that is continuously produced by the choroid plexuses of the cerebral ventricles and circulates around the surface of the brain and spinal cord
Cohort 1 were used for the analysis of CSF and serum albumin and IgG levels and for the determination of an intrathecal IgG synthesis
CSF median levels of IgG and albumin were more elevated in men than in women (4.63 vs. 3.59 mg/dL and 29.7 vs. 19.2 mg/dL, respectively) with no differences between sexes for IgG and albumin in serum samples
Summary
Cerebrospinal fluid (CSF) is a watery body fluid that is continuously produced by the choroid plexuses of the cerebral ventricles and circulates around the surface of the brain and spinal cord. CSF typically contains low protein concentrations and few circulating cells [1]. Cerebrospinal fluid (CSF) protein content presents a sexual dimorphism in humans. We investigated sex-related differences in CSF IgG levels and in the quantification of intrathecal IgG synthesis (IIS). Methods: CSF, serum albumin and IgG were measured in 1519 neurological patients and both linear and hyperbolic formulas were used for the quantification of IIS. Higher CSF albumin and IgG levels were found in men than in women in the whole population and in subjects without IIS after adjusting for age and for serum concentrations of albumin and IgG, respectively (Quade statistics, p < 0.000001). CSF and serum albumin and IgG levels positively correlated to age in both sexes. Conclusions: In neurological patients, men have higher levels of CSF serum-derived proteins, such as albumin and IgG
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