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TABLE 9.6 Normal values for the formula of Tourtellotte (authors taken from Table 9.4) 6. 0.12 0.16 12. 0.23 0.33 Behring antibody 0.23 0.33 in slope. Finally, although with smaller numbers and over a narrower range of barrier damage, Eickhoff's data also shows a 50 per cent increase in slope 240 . A further discussion of similar changes in slope (increase) with other proteins has been presented in Chapter 8. In spite of this caveat, values are presented for the normal range of...

Foreword

In this book, Professor Thompson, an MD and DSc (neurochemistry), has continued to focus on cerebrospinal fluid (CSF) proteins by organizing information and knowledge on the nature of CSF proteins in health and disease, as well as the best methods to detect them in addition, he has integrated his decades of experience and discoveries. This makes for an encyclopedia type of book for laboratory directors, experimentalists, lecturers, writers and newcomers. An important message of the book is his...

Ser Csf Ser Csf Ser

FIGURE 13.1B Kappa Lambda staining to show a band with only lambda (bottom). What is the meaning of oligoclonal bands in the patient with optic neuritis It has been suggested that they have predictive value in patients with optic neuritis in that they can help to indicate those who will go on to develop MS. However, performing the Fischer exact test (Chi square) on the data of Sandberg-Wollheim shows no such significant correlation 977 . In another study 1093 the use of two groups with...

Different sources of CSF proteins

Csf Barriers

The individual blood-CSF barriers (or sources) produce characteristic fluids, each with different proteins (differentiated mainly by their size). These discrete fluids then mix according to the unusual flow dynamics of the CSF. Circulation of the blood through the brain is unlike that in any other organ of the body. This was dramatically demonstrated by intravenous injection of the blue dye (which is immediately bound to albumin), when the entire animal became blue except for the brain which...

Beta 2 Transferrin Dementia

Insertion of external ventricular drain Insertion of new external ventricular drain Serial CSF ( ) and serum S-100b ( ) concentrations FIGURE 11.6 Ventricular drain showing the rapid clearance of S-100 protein from CSF into serum over 12 hours. Myelin associated glycoprotein (MAG) Although this protein does not seem to be found intact in the CSF, there appear to be fragments of this protein in normal subjects as well as in various neurological diseases 1311 . Major oligodendrocyte glycoprotein...

CNS immunoglobulin synthesis

Introduction Efficient diagnosis Differential diagnosis Specific antigens Technology General methods for protein separation visualization Separation by isoelectric focusing Antigen-specific immunoblotting Dot-blots Relative specific antibody on Eastern blots CSF versus MRI Serum source of CSF antibodies Focusing of serum and parallel CSF Differential diagnosis of serum bands Serum oligoclonal bands in MS Paraneoplastic serum and CSF antibodies Conclusion The presence of oligoclonal bands in CSF...

Chapter

Mathematics of the multiple sources of CSF proteins Conclusion Each CSF protein should be considered in the first instance to have a primary serum source and to have a concentration gradient which drives it across various barriers, whose degree of filtration or effectiveness can readily change. However, proteins can be synthesized and or modified within the confines of the theca. These three factors must always be included in any equation serum level, function of barrier(s), and local synthesis...

C S C S C S C S

FIGURE 10.7 HRP immunostain ('one' artefactual band). In practical terms, using the silver stain produces a very high level of 'noise' which unfortunately obscures any of the pathological (oligoclonal) bands with the large number of 'pseudo-bands' which simply reflect the serious inhomogeneities in the underlying ampholytes (see Figure 10.6). This is also seen in the staining of the ampholytes themselves in the absence of any protein (see Chapter 15, Figure 15.3). Conversely, the incidence and...

C S C S C S C S C S C S C S C S C S

FIGURE 15.1 Isoelectric focusing of CSF followed by specific immunofixation against IgG, foot region (Fc). FIGURE 15.2 SDS gel electrophoresis of CSF (after reducing agent) to show elevated amounts of heavy chains (white lines, B) compared to amounts of transferrin (white lines, A). The upper arc (C) is light chains the lower arc (D) is prealbumin. Samples are (left to right) normal, MS, brain tumor (serum leak), and paraprotein (note lower molecular weight fragments delimited by squared white...

D

QUALITATIVE VERSUS QUANTITATIVE ANALYSIS TABLE 6.3 Qualitative versus quantitative tests for IgG A Serum level serum increase produces increase in CSF B Barrier 'setting' more leakage produces increase in CSF C Local synthesis distinct from either of the above 2. Qualitative kind of IgG more 'important' than above, but again 'both' performed, i.e. quantitative analysis of clones B Monoclonal usually serum source C Oligoclonal usually CSF source, rule out serum source TABLE 6.4...

Investigators of CSF proteins

Although one can always return to the past and reawaken some of the earliest interests in the 'water of the brain', a clear start to modern biochemical analysis began in 1942 515 . Elvin Kabat, a biochemist working at Columbia Presbyterian Hospital in New York City, showed, using the Tiselius electrophoresis apparatus, that CSF differed from serum in that prealbumin which he termed protein 'X' was specific to spinal fluid. For these analyses, he required up to 70 ml of CSF - i.e. approximately...

T

FIGURE 5.5 Normal barriers which can become abnormal spinal roots. FIGURE 5.6 Abnormal barriers meninges. FIGURE 5.6 Abnormal barriers meninges. The meninges, another normally minor source, become prominent in disease. They may become very leaky when inflamed as a result of bacterial or viral infection or even secondary carcinoma, as depicted in Figure 5.6. Under various pathological conditions described in detail in Chapters 10 and 11 there are eight other protein patterns see Table 5.1 . Once...