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Immune Response in the CSF in Viral Infections

1983; Elsevier BV; Linguagem: Inglês

10.1016/s0079-6123(08)63858-3

1875-7855

H. Siemes, Martín J. Siegert,

Bacterial Infections and Vaccines

The local humoral immune response in inflammatory diseases of the central nervous system (CNS) is reflected by an increase in gamma-globulin in the cerebrospinal fluid (CSF) and, more significantly, by the occurrence of oligoclonal gamma-banding. In the detection of local immunoglobulin synthesis, the possibility of changes in the serum gamma-globulin and increased permeability of the blood-CSF barrier to proteins has to be taken into consideration. This chapter evaluates the gamma-globulin reaction in various acute, prolonged, and chronic CNS-infections of viral or presumed viral origin. In addition, the degree of the concomitant blood-CSF barrier disturbance is determined. By stereotyped changes of the CSF-protein spectrum, two pathologic reactions can be defined: the pattern of local immune response, and the pattern of blood-CSF barrier disturbance. The chapter focuses on the local immune response that leads to increase of gamma3-globulin and synthesis of oligoclonal gamma-fractions. In acute aseptic meningitis, minimal or no abnormal gamma-globulin increases are observed. In acute para- and postinfectious encephalitis, however, a marked local humoral immune response may occur. The most striking increases in gamma-globulin can be noticed in herpes simplex virus encephalitis during phases of clinical improvement.