Studies on rubella. II. Rubella antibodies in the cerebrospinal fluid with rubella meningoencephalitis (author's transl)

Abstract

There have been a few reports of finding specific viral antibody in cerebrospinalfluid (C. S. F.) with rubella meningoencephalitis.C. S. F. from twelve patients with rubella meningoencephalitis were examinied forantibody to rubella by following techniques:Hemagglutination inhibition (HI) antibody determination was done using the standard microtitration technique. C. S. F. was not pretreated with kaolin to remove non-specific inhibitors because there was insufficient protein in C. S. F. to saturate the kaolin, and thus the range of dilution could be satarted with undiluted specimens.Neutralization test (NT) antibody was titrated employing plaque count method.Complement fixation (CF) antibody was examined with common microtitration technique.The results are as follows:1. Rubella HI antibody was found in the C.S.F. of all twelve patients. The HI antibody titer ranged from 1: 2 to 1: 128. The peak antibody level showed in acute phase and it decreased slowly depending on the day of illness. This pattern was opposite to the serum antibody pattern.2. Rubella NT antibody was found in the C.S.F. of six out of ten patients. The NT antibody titer ranged from 1: 2 to 1: 32. The NT antibody pattern depended on the day of illness and was similar to HI pattern.3. Rubella CF antibody was found in the C.S.F. of four out of ten patients. The CF antibody titer ranged from 1: 2 to 1: 8. The CF antibody pattern was similar to the NT pattern.4. An average serum/C. S. F. antibody ratio was as follows.First ten days after the onset, it was 65 for HI and 60 for NT. Ten to fifteen days after the onset, it was 153 for HI and 384 for NT and after sixteen days, 523 for HI and 768 for NT.5. No antibodies were found in the C.S.F. of the nineteen controls who had negative serum rubella HI antibody. In the case of another control group with all positive HI's in the serum, 16/19 (HI), 15/16 (NT) and 12/13 (CF) had negative titers. The positive cases were a mycoplasma encephalitis, a bacterial meningitis, an aseptic meningitis and an acute leukemia. The maximum antibody level of these cases was 1: 4.6. These results confirmed that rubella antibody could be found in the C.S.F. of the rubella meningoencephalitis and it could be diagnosed rapidly to determined the HI antibody titers in the C. S. F. It was also suggested that the rubella virus which was probably in the central nervous system could be neutralized by the antibody in the C. S. F.The further studies are required to clarify if these antibodies were produced in the central nervous systems or their localization there is due to a leak of the serum antibody through a hyperpermeable blood-brain-barrier.