Detection Of Intrathecal Synthesis Research Articles

Non-linear ventriculo – Lumbar protein gradients validate the diffusion-flow model for the blood-CSF barrier

BackgroundConcentrations of blood-derived proteins increase non-linearly between ventricular and lumbar CSF, which could not be satisfactorily explained by known barrier models. MethodsProtein data analysis with OriginLab. Interpretations with Quotient diagrams by CSF/ Statistics software. Results1. Nonlinearly increasing protein concentrations between ventricular and lumbar CSF are fitting to a Gaussian error function, the differential of the nonlinear concentration distribution function between blood and CSF. Increasing CSF protein concentrations (changing steady state), either due to barrier dysfunctions with reduced CSF flow rate or due to normal steady influx along the rostro-caudal flow path, increase the local gradient at the diffusion flow interface and thus the molecular current through the barrier.2. With a time- and space-related derivation, the hyperbolic relation between two molecules in CSF (e.g., QIgG: QAlb in quotient diagrams) is independent of the position in subarachnoid space: The reference line, Qlim, in quotient diagrams allows detection of intrathecal synthesis in ventricular, cisternal and lumbar CSF. Detection of intrathecal synthesis is not influenced by CSF extraction volume, only the barrier function, QAlb, is volume sensitive. ConclusionsCommon biophysics for barrier dysfunction and normal protein gradients provide additional evidence for the diffusion-flow interface model for barrier functions.

Doit-on faire une ponction lombaire devant toute paralysie faciale suspecte de borréliose de Lyme chez l’enfant ?

Lyme borreliosis should be considered in any child affected with acute peripheral facial palsy without obvious cause in endemic areas, especially if it happens from May to November, with a history of erythema migrans, tick bite, or possible exposure during the previous weeks. The clinical appearance of Lyme borreliosis differs between adults and children and according to the geographical origin of the infection: therefore it is difficult to interpret and follow the recommendations for the management and treatment of this disease. Neuroborreliosis is more frequent in Europe than in the United States, and meningitis associated to facial palsy occurs earlier and is more frequent among the European pediatric population, too. When peripheral facial palsy occurs and there is suspicion of Lyme borreliosis, it seems necessary to perform a lumbar puncture in order to support the diagnosis with detection of intrathecal synthesis of specific antibodies, sometimes more abundant than in the serum, and thus to adapt the antibiotic therapy modalities. Parenteral antibiotherapy is recommended if any involvement is detected in the cerebrospinal fluid, while oral antibiotherapy should be prescribed for isolated facial palsies. Follow-up should be made according to clinical symptoms with a close collaboration between pediatricians, infection disease specialists, and ENT specialists.

A combined indirect elisa and immunoblotting for the detection of intrathecal herpes simplex virus igg antibody synthesis in patients with herpes simplex virus encephalitis

A combined indirect ELISA and immunoblotting assay was used for the detection of intrathecal synthesis of IgG antibodies to herpes simplex virus (HSV) in patients with HSV encephalitis (HSVE). By using these two assays as well as three markers for blood-brain barrier, leakage can be easily excluded. A total of 21 sera and 24 cerebrospinal fluid (CSF) samples from 11 patients with HSVE were examined. For seven patients more than one pair of serum and CSF were available. For one patient IgG antibodies began to be detectable in CSF after the sixth day from the onset of the disease. In the other 10 patients the intrathecal synthesis of HSV IgG antibodies was detected later than the sixth day and reached high optical density (OD) values after the 10th day from the onset of disease, at the earliest. In contrast, intrathecal HSV antibody synthesis was not found in specimens taken from 20 patients with acute meningitis who composed our negative control group. The use of a combined indirect ELISA and of an immunoblotting assay on a single dilution of serum and CSF for HSV IgG synthesis in the central nervous system (CNS) allowed the diagnosis of HSVE after the first week of disease.