DISCRIMINATION OF ELEVATED IMMUNOGLOBULIN CONCENTRATIONS IN CSF DUE TO INFLAMMATORY REACTION OF THE CENTRAL NERVOUS SYSTEM AND BLOOD-BRAIN-BARRIER DYSFUNCTION

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Abstract
Inflammatory reactions of the [human] CNS are diagnosed by the determination of elevated immunoglobulin [Ig] concentrations in CSF due to local production of Ig. Nonspecific disturbances of the blood-brain-barrier (BBB) can also cause an increase of CSF Ig concentration as a result of filtration from serum. The methods described were used to produce a more precise characterization of Ig in CSF and to define that portion of CSF Ig derived from the CNS. Albumin and IgG, IgA and IgM were determined in serum and CSF. The ratio of albumin in serum and CSF is taken as an indicator of BBB function. By determining the quotients, an Ig elevation in the CSF (as an expression of an inflammatory reaction) could be detected. Methodological problems and the definition of normal ranges were discussed.