Skip to main content
SpringerLink
Log in

Isoelectric focusing and quantitative estimation of cerebrospinal fluid and serum IgG in idiopathic polyneuropathy

  • Original Investigations
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Summary

Isoelectric focusing and quantitative estimation of serum and CSF IgG were performed in 85 patients with idiopathic polyneuropathy (IP), subdivided according to the clinical course (acute, subacute, recurrent, chronic). Acute IP very frequently had an increase of oligoclonal and/or polyclonal serum IgG during the progressive phase and blood-CSF barrier damage accompanied by polyclonal IgG intrathecal synthesis during the stationary phase. Polyclonal IgG intrathecal synthesis was also present in several not acute IP and seemed to forecast unfavorable course. Oligoclonal IgG synthesis occurs very rarely within CSF but is a frequent finding in serum of patients with IP. Abnormalities of the IgG serum pattern are neither specific for any clinical course of IP nor of prognostic value. The possible significance of such findings is discussed.

Zusammenfassung

Isoelektrische Fokussierung und quantitative Schätzung von Serum-IgG und Liquor wurden in 85 Patienten mit idiopathischer Polyneuropathie (IP), die schon nach dem klinischen Verlauf (akute, subakute, rückfällige, chronische) unterschiedlich waren, durchgeführt. Akute IP zeigte eine Erhöhung von oligoklonalem und/oder polyklonalem Serum-IgG bei der progressiven Phase. Eine Störung der Blut-Liquor-Schranke mit polyklonaler IgG-intrathekaler Synthese lag auch in verschiedenen nicht akuten IP vor. Sie scheinen einen ungünstigen Verlauf anzuzeigen. Oligoklonale IgG-Synthese ereignet sich sehr selten im Liquor (Blut-Liquor-Schranke), aber sie ist ein häufiger Befund im Serum der Patienten mit IP. Regelwidrigkeiten in der IgG-Zusammensetzung im Serum scheinen weder spezifisch von einem bestimmten klinischen Verlauf der IP abzuhängen, noch von prognostischem Wert zu sein. Die mögliche Bedeutung solcher Befunde wird erörtert.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Abramski, O., Webb, C., Teitalbaum, D., Arnon, R.: Cell mediated immunity to neural antigens in idiopathic polyneuritis and myeloradiculitis. Neurology 25, 1154–1159 (1975)

    Google Scholar 

  2. Arnason, B. G.: Idiopathic polyneuritis (Landry-Guillain-Barré-Strohl syndrome) and experimental allergic neuritis: a comparison. In: Immunological disorders of the nervous system, L. P. Rowland (ed.), pp. 156–177. Baltimore: William and Wilkins 1971

    Google Scholar 

  3. Behan, P. O., Currie, S.: The Landry-Guillain-Barré-Strohl syndrome. In: Clinical neuro-immunology, P. O. Behan, S. Currie (eds.), pp. 81–96. London: Saunders 1978

    Google Scholar 

  4. Bours, J.: The use of protein markers in thin layer isoelectric focusing. Sci. Tools 20, 29–34 (1973)

    Google Scholar 

  5. Castaigne, P., Brunet, P., Mouailhat, F.: Enquete clinique sur les polyradiculonévrites inflammatoires en France. Rev. Neurol. 115, 849–872 (1966)

    Google Scholar 

  6. Chazot, G., Berger, B., Carrier, H., Barbaret, C., Bady, B., Dumas, R., Creyssel, R., Schott, B.: Manifestation neurologiques des gammopathies monoclonales. Rev. Neurol. 132, 195–212 (1976)

    Google Scholar 

  7. Cook, S. D., Dowling, P. C., Murray, M. R., Whitaker, J. N.: Circulating demyelinating factors in acute idiopathic polyneuropathy. Arch. neurol. 24, 136–144 (1971)

    Google Scholar 

  8. Davies, H.: Thin layer isoelectric focusing. In: Isoelectric focusing, J. P. Arbutnott, A. Beeley (eds.), pp. 97–113. London: Butterworths 1973

    Google Scholar 

  9. Delpech, B., Lichtblau, E.: Etude quantitative des immunoglobulins G et de l'albumin du liquide cephalorachidien. Clin. Chim. Acta 37, 15–23 (1972)

    Google Scholar 

  10. Delmotte, P., Demonty, L.: Biochemical findings in multiple sclerosis. II: A detailed study of serum IgG, IgA, IgM levels in 772 multiple sclerosis patients compared with 226 neurological controls. J. Neurol. 211, 135–142 (1976)

    Google Scholar 

  11. Delmotte, P., Gonsette, R.: Biochemical findings in multiple sclerosis. IV: Isoelectric focusing of CSF gamma globulins in multiple sclerosis and other neurological diseases. J. Neurol. 215, 27–37 (1977)

    Google Scholar 

  12. Dubois-Dalcq, M., Buyse, M., Buyse, G., Gorce, F.: The action of Guillain-Barré syndrome serum on myelin. A tissue culture and electron microscopic analysis. J. Neurol. Sci. 13, 67–83 (1971)

    Google Scholar 

  13. Hayamaker, W., Kernohan, J. W.: The Landry-Guillain-Barré syndrome. A clinicopathologic report of fifty fatal cases and a critique of the literature. Medicine 38, 59–140 (1949)

    Google Scholar 

  14. Hinaman, R. C., Magee, K. R.: Guillain-Barré syndrome with a slow progressive onset and persistent elevation of spinal fluid protein. Ann. Inter. Med. 67, 1007–1013 (1967)

    Google Scholar 

  15. Iwashita, H., Inoue, N., Nagamatsu, K.: Polyneuropathy, pigmentation, diabetes mellitus and monoclonal gammopathy. Clin. Neurol. 11, 492–499 (1971)

    Google Scholar 

  16. Jensen, K. G.: Cerebrospinal fluid proteins in neurological diseases. Acta Neurol. Scand. 58, supp. 70, 75–87 (1978)

    Google Scholar 

  17. Kjellin, K. G., Vesterberg, O.: Isoelectric focusing of CSF proteins in neurological diseases. J. Neurol. Sci. 23, 199–213 (1974)

    Google Scholar 

  18. Kjellin, K. G., Siden, A.: Cerebrospinal fluid findings on isoelectric focusing in known or probable infections of the nervous system, including Guillain-Barré syndrome. In: Proc. of the 11th World Congress of Neurology, Abs. N. 427, pp. 95–96. Amsterdam: Excerpta Medica 1977

    Google Scholar 

  19. Kohn, J.: Benign paraproteinaemia. J. Clin. Pathol. 28, 77–82 (1976)

    Google Scholar 

  20. Lamoreaux, G., Jolicoeur, R., Giard, N., St Hilaire, M., Duplantis, F.: Cerebrospinal fluid proteins in multiple sclerosis and other diseases of the nervous system. Neurology 25, 537–546 (1975)

    Google Scholar 

  21. Laterre, E. C., Callawaert, A., Heremans, J. F.: Electrophoretic morphology of gammaglobulins in cerebrospinal fluid of multiple sclerosis and other diseases of the nervous system. Neurology 20, 982–990 (1970)

    Google Scholar 

  22. Leneman, F.: The Guillain-Barré syndrome. Arch. Int. Med. 118, 139–144 (1966)

    Google Scholar 

  23. Link, H.: Immunoglobulin abnormalities in the Guillain-Barré syndrome. J. Neurol. Sci. 18, 11–23 (1973)

    Google Scholar 

  24. Link, H.: Demonstration of oligoclonal immunoglobulin G in Guillain-Barré syndrome. Acta Neurol. Scand. 52, 111–120 (1975)

    Google Scholar 

  25. Livrea, P., Zimatore, G. B., Simone, I. L., Lepore, V., Trojano, M., Loreto, M., De Blasi, A., Gennarini, G. F.: Isoelectric focusing and crossed immunoisoelectric focusing of cerebrospinal fluid proteins in neurological disorders. Acta Neurol. 33, 501–517 (1978)

    Google Scholar 

  26. Lowenthal, A.: Agar gel electrophoresis in neurology. Amsterdam: Elsevier 1964

    Google Scholar 

  27. Lowry, O. H., Rosebrough, N. J., Farr, A. L., Randall, R. J.: Protein measurement with the Folin phenol reagent. J. Biol. Chem. 193, 265–275 (1951)

    Google Scholar 

  28. Masucci, E. F., Kurtzke, J. F.: Diagnostic criteria for the Guillain-Barré syndrome. J. Neurol. Sci. 13, 483–501 (1971)

    Google Scholar 

  29. Nyland, H., Naess, A.: Lymphocite subpopulations in blood and cerebrospinal fluid from patients with acute Guillain-Barré syndrome. Eur. Neurol. 17, 247–252 (1978)

    Google Scholar 

  30. Osler, L. D., Sidell, A. D.: The Guillain-Barré syndrome. New Engl. J. Med. 262, 964–969 (1960)

    Google Scholar 

  31. Olsson, J. E., Petterson, B.: A comparison between agar gel electrophoresis and cerebrospinal fluid serum quotients of IgG and albumin in neurological diseases. Acta Neurol. Scand. 53, 308–318 (1975)

    Google Scholar 

  32. Prineas, J.: Polyneuropathies of undetermined cause. Acta Neurol. Scand. 46, supp. 44, 1–70 (1970)

    Google Scholar 

  33. Read, D. J., Vanhegan, R. I., Matthews, W. B.: Peripheral neuropathy and benign IgG paraproteinaemia. J. Neurol. Neurosurg. Psych. 41, 215–219 (1978)

    Google Scholar 

  34. Rieder, H. P., Kaeser, H. E., Nusselt, L.: Liquorproteinveränderungen bei Polyneuritis. Schweiz. Med. Wschr. 102, 766–772 (1972)

    Google Scholar 

  35. Rosenberg, R. N., Aung, M. H., Tindall, R. S. A., Molenich, S., Baskin, F., Capra, J. D., Toben, H. R.: Idiopathic polyneuropathy associated with cytotoxic anti-neuroblastoma serum. Neurology 25, 1101–1110 (1975)

    Google Scholar 

  36. Schliep, G., Felgennauer, K.: Serum-CSF protein gradient, the blood-CSF barrier and the local immune response. J. Neurol. 218, 77–96 (1978)

    Google Scholar 

  37. Siden, A., Kjellin, K. G.: Isoelectric focusing of CSF and serum proteins in neurological disorders, combined with benign or malignant proliferations of reticulocytes, limphocytes and plasmocytes. J. Neurol. 216, 251–264 (1977)

    Google Scholar 

  38. Siden, A.: Crossed immunoelectrofocusing of cerebrospinal fluid immunoglobulins. J. Neurol. 217, 103–109 (1977)

    Google Scholar 

  39. Siden, A., Kjellin, K. G.: Isoelectric focusing of CSF proteins in known or probable infectious neurological diseases and the Guillain-Barré syndrome. J. Neurol. Sci. 42, 1–15 (1979)

    Google Scholar 

  40. Soderholm, C., Smyth, J.: Crossed immunoelectric focusing for studies on protein microheterogeneity. In: Progress in isoelectric focusing, P. G. Righetti (ed.), pp. 99–114. Amsterdam: North Holland 1975

    Google Scholar 

  41. Stibler, H.: The normal cerebrospinal fluid proteins identified by means of thin layer isoelectric focusing and crossed immunoelectric focusing. J. Neurol. Sci. 36, 273–288 (1978)

    Google Scholar 

  42. Stibler, H.: Isoelectric focusing of cerebrospinal fluid proteins in degenerative diseases of the central nervous system. Ph. D. Thesis. Stockholm: Karolinska Hospital 1978

    Google Scholar 

  43. Tse, K. S., Arbesam, C. E., Tomasi, T. B., Tourville, D.: Demonstration of antimyelin antibodies by immunofluorescence in Guillain-Barré syndrome. Clin. Exp. Immunol. 8, 880–887 (1971)

    Google Scholar 

  44. Yonezawa, T., Ishihara, Y., Matsuyama, H.: Studies on experimental allergic peripheral neuritis. I: Demyelinating patterns studied in vitro. J. Neuropathol. Exp. Neurol. 27, 453–463 (1968)

    Google Scholar 

  45. Vesterberg, O.: Isoelectric focusing of proteins in polyacrylamide gels. Biochim. Biophys. Acta 257, 11–19 (1972)

    Google Scholar 

  46. Vesterberg, O.: Isoelectric focusing of proteins in thin layer of polyacrylamide gel. Sci. Tools 20, 22–29 (1973)

    Google Scholar 

  47. Whitaker, J. M., Sciabbarasi, B. S., Engel, W. K., Warmolts, J. R., Strober, W.: Serum immunoglobulin and complement (C3) levels. A study in adults with idiopathic chronic polyneuropathies and motor neuron diseases. Neurology 23, 1164–1173 (1973)

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, University of Bari, Bari, Italy

    P. Livrea, G. B. Zimatore, I. L. Simone, M. Trojano, V. Lepore, V. Ferrara, F. A. Lupo & D. Pedone

Authors
  1. P. Livrea
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. B. Zimatore
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. I. L. Simone
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Trojano
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. V. Lepore
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. V. Ferrara
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. F. A. Lupo
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. D. Pedone
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Livrea, P., Zimatore, G.B., Simone, I.L. et al. Isoelectric focusing and quantitative estimation of cerebrospinal fluid and serum IgG in idiopathic polyneuropathy. J. Neurol. 223, 1–12 (1980). https://doi.org/10.1007/BF00313135

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00313135

Key words

Search

Navigation