This paper briefly reviews the factors which influence the concentrations of proteins, particularly immunoglobulins, within the CSF and how antibodies which are locally synthesized within the central nervous system can be detected by the laboratory. The use of nitrocellulose immunoblotting for the identification of antibodies which are specific to Treponema pallidum and Human Immunodeficiency Virus Type-1 are discussed.
AarliJA.The immune system and the nervous system. J Neurol1983;229:137–54.
2.
FelgenhauerK.Protein filtration and secretion at human body fluid barriers. Pflügers Arch1980;384:9–17.
3.
CserrHFKnopfPM.Cervical lymphatics, the blood-brain barrier and the immunoreactivity of the brain: A new view. Immunol Today1992;13:507–12.
4.
LukehartSAHookEWBaker-ZanderSACollierACCritchlowCWHandsfieldHH.Invasion of the central nervous system by Treponema pallidum: Implications for diagnosis and treatment. Ann Intern Med1988;109:855–62.
5.
MooreJEHopkinsHH.Asymptomatic neurosyphilis VI: The prognosis of early and late asymptomatic neurosyphilis. JAMA1930;95:637–1641.
6.
NiemanEA.Neurosyphilis yesterday and today. J R Coll Phys Lond1991;25:321–4.
7.
ThinRNBarlowD.Syphilis yesterday and today: Letter to the Editor. J R Coll Phys Lond1992;26:238.
8.
MusherDM.Syphilis, neurosyphilis, penicillin, and AIDS. J Infect Dis1991;163:1201–6.
9.
HaasJSBolanGLarsenSAClementMJBacchettiPMossAR.Sensitivity of treponemal tests for detecting prior treated syphilis during human immunodeficiency virus infection. J Infect Dis1990;162:862–6.
10.
KatzDABergerJR.Neurosyphilis in AIDS. Arch Neurol1989;46:895–8.
11.
PlatouRV.Treatment of congenital syphilis. Adv Paediatr1949;4:39–81.
12.
JaffeHWKabinsSA.Examination of cerebrospinal fluid in patients with syphilis. Rev Infect Dis, 1982;4(suppl):842–7.
13.
LugerA.Diagnosis of syphilis. Bull World Health Organization1981;59:647–54.
14.
DavisLESchmittJW.Clinical significance of cerebrospinal fluid tests for neurosyphilis. Ann Neurol1989;25:50–5.
15.
Treponemal Infections. WHO Tech Rep Ser1982;674:34.
16.
TuffanelliDLWuepperKDBradfordLLWoodRM.Fluorescent treponemal-antibody absorption tests: Studies of false-positive reactions for syphilis. N Engl J Med, 1967;276:258–62.
17.
Editorial. Routine tests for syphilis on cerebrospinal fluid. Lancet1977;ii:595.
18.
DansPECaffertyLOtterSEJohnsonRJ.Inappropriate use of the cerebrospinal fluid venereal disease research laboratory (VDRL) test to exclude neurosyphilis. Ann Intern Med1986;104:86–9.
19.
DansPEVernonTRusellB.Cerebrospinal fluid serology—is its routine use justifiable?Public Health Rep1977;92:260–2.
20.
DavisLESchmittJW.Clinical significance of cerebrospinal fluid tests for neurosyphilis. Ann Neurol1989;25:50–5.
21.
LugerASchmidtBLSteyrerKSchonwaldE.Diagnosis of neurosyphilis by examination of the cerebrospinal fluid. Br J Vener Dis1981;57:232–7.
22.
PrangeHWMoskophidisMSchipperHIMullerF.Relationship between neurological features and intrathecal synthesis of IgG antibodies to Treponema pallidum in untreated and treated human neurosyphilis. J Neurol1983;230:241–52.
23.
MullerFMoskophidesM.Estimation of the local production of antibodies to Treponema pallidum in the central nervous system of patients with neurosyphilis. Br J Vener Dis1983;59:80–4.
24.
JaffeHWLarsenSAPetersMJoveDFLopezBSchroeterAL.Tests for treponemal antibody in CSF. Arch Intern Med1978;138:252–5.
25.
JonesRRPuseyCSchifferliJ.Essential mixed cryoglobulinaemia with false positive serologic tests for syphilis. Br J Vener Dis1983;59:33–6.
26.
SimonRP.Neurosyphilis. Arch Neurol1985;42:606–13.
27.
HartG.Syphilis tests in diagnostic and therapeutic decision making. Ann Intern Med1986;104:368–76.
28.
LewisLLTaberLHBaughnRE.Evaluation of immunoglobulin M Western blot analysis in the diagnosis of congenital syphilis. J Clin Microbiol1990;28:296–302.
29.
SanchezPJMcCrackenGHWendelGDOlsenKThrelkeldNNorgardMV.Molecular analysis of the fetal IgM response to Treponema pallidum antigens: Implications for improved diagnosis of syphilis. J Infect Dis1989;159:508–17.
30.
SanchezPJWendelGDNorgardMV.IgM antibody to Treponema pallidum in cerebrospinal fluid of infants with congenital syphilis. Am J Dis Child1992;146:171–5.
31.
KaufmanREOlanskyDCWiesnerPJ.The FTA-ABS (IgM) Test for neonatal congenital syphilis: A critical review. J Am Vener Dis Assoc1974;1:79–84.
32.
MullerFLindenschmittEG.Demonstration of specific 19S (IgM) antibodies in untreated and treated syphilis. Br J Vener Dis1982;58:12–17.
33.
DobsonSRMTaberLHBaughnRE.Recognition of Treponema pallidum antigens by IgM and IgG antibodies in congenitally infected newborns and their mothers. J Infect Dis1988;157:903–10.
34.
OxeliusVRorsmanHLaurellA.Immunoglobulins of the cerebrospinal fluid in syphilis. Br J Vener Dis1969;45:121–5.
35.
LinkHMullerR.Immunoglobulin in multiple sclerosis and infections of the nervous system. Arch Neurol1971;25:326–44.
36.
HischeEAHTutuarimaJAWoltersEChCerebrospinal fluid IgG and IgM indexes as indicators of active neurosyphilis. Clin Chem1988;34:665–7.
37.
WoltersECHischeEAHTutuarimaJACentral nervous system involvement in early and late syphilis; the problem of asymptomatic neurosyphilis. J Neurol Sci1988;88:229–39.
38.
BoeerASchipperHIPrangeHW.Local IgM production in Meningoradilculitis Bannwarth and Neurosyphilis. J Neuroimmunol1988;20:315–6.
39.
VartdalFVandvikBMichaelsonTELoeKNorrbyE.Neurosyphilis: Intrathecal synthesis of oligoclonal antibodies to Treponema pallidum. Ann Neurol1982;11:35–40.
40.
MullerFMoskophidisMSchmitzH.Intrathecal synthesis of specific IgG in syphilitic patients with human immunodeficiency virus 1 infection. J Neurol1988;234:252–3.
41.
MazzarelloPPoloniMCitterioACamanaCCeroniM.Cerebrospinal fluid IgG changes in neurosyphilis after high dose Penicillin G treatment (Utter). Arch Neurol1984;44:249.
42.
HensMJLolliFMartin-MoroMGimenez-RoldanSLinkH.High dose intravenous penicillin in neurosyphilis: Effect on intrathecal synthesis of IgG, IgM, IgA and IgD. Acta Neurol Scand1990;82:381–5.
43.
Van WielinkGMcArthurJCMoenchTIntrathecal synthesis of anti-HIV IgG: Correlation with increasing duration of HIV-1 infection. Neurology1990;40:816–9.
44.
HallCDSnyderCRRobertsonKRCerebrospinal fluid analysis in human immunodeficiency virus infection. Ann Clin Lab Sci1992;22:139–43.
45.
McArthurJCNance-SprosenTEGriffinDEThe diagnostic utility of elevation in cerebrospinal fluid Beta-2 microglobulin in HIV-1 dementia. Multicentre AIDS cohort study. Neurology1992;42:1707–12.
46.
JanssenRS.Nomenclature and research case definitions for neurologic manifestations of human immunodeficiency virus Type-1 (HIV-1) infection. Report of a working group of the American Academy of Neurology AIDS Task Force. Neurology1991;41:778–85.
47.
ChiodiFNorkansGHagbergLHuman immunodeficiency virus infection of the brain II: Detection of intrathecally synthesised antibodies by enzyme linked immunosorbent assay and imprint immunofixation. J Neurol Sci1988;87:37–48.
48.
McArthurJCCohenBAFarzedeganHCerebrospinal fluid abnormalities in homosexual men with and without neuropsychiatric findings. Ann Neurol1988;23(suppl):S34–S37.
49.
AckermannRNekicMJurgensR.Locally synthesised antibodies in cerebrospinal fluid of patients with AIDS. J Neurol1986;233:140–1.
50.
LolliFColaoMGDe MaioEIntrathecal synthesis of anti-HIV antibodies in AIDS patients. J Neurol Sci1990;99:281–9.
51.
SkotzekBSanderTZimmermannJKolmelHW.Oligoclonal bands in serum and cerebrospinal fluid of patients with HIV infections. J Neuroimmunol1988;20:151–2.
52.
ReboulJSchullerEPialouxGImmunoglobulins and complement components in 37 patients infected with HIV-1 virus: Comparison of general (systemic) and intrathecal immunity. J Neurol Sci1989;89:243–52.
53.
KaiserRDorriesRLuerWAnalysis of oligoclonal antibody bands against individual HIV structural proteins in the CSF of patients infected with HIV. J Neurol1989;236:157–60.
54.
AmadoriADe RossiAGalloPTavolatoBChieco-BianchiL.Cerebrospinal fluid lymphocytes from HIV-infected patients synthesise HIV-antibodies in vitro. J Neuroimmunol1988;18:181–6.
55.
SinclairDGallowayEMcKenzieSFollettEACWallaceL.Oligoclonal immunoglobulins in HIV infections. Clin Chem1989;35:1669–71.
56.
GalloPPiccinnoMGDe RossiAFree light chains of immunoglobulins in the cerebrospinal fluid of human immunodeficiency virus Type 1-infected patients. J Neuroimmunol1990;26:229–38.
57.
GrimaldiLMECastagnaAMaimoneDKappa light chain predominance in serum and cerebrospinal fluid from human immunodeficiency virus Type-1 (HIV-1) infected patients. J Neuroimmunol1991;32:259–68.
58.
LiuzziGMMastroianniCMVulloVJirilloEDeliaSRiccioP.Cerebrospinal fluid myelin basic protein as predictive marker of demyelination in AIDS dementia complex. J Neuroimmunol1992;36:251–4.
59.
BognerJRJunge-HulsingBKronwitterUSadriIMatuschkeAGoebelFD.Expansion of neopterin and Beta-2 microglobulin in cerebrospinal fluid reaches maximum levels early and later in the course of human immunodeficiency virus infection. Clin Invest1992;70:665–9.
60.
ElovaaraIBykyriEPoutiainenEHokkanenLRaininkoRSuniJ.CSF follow-up in HIV-1 infection: Intrathecal production of HIV-specific and unspecific IgG and Beta-2-microglobulin increase with duration of HIV-1 infection. Acta Neurol Scand1993;87:388–96.
61.
BrewBJBhallaRBPaulMCerebrospinal fluid neopterin in human immunodeficiency virus Type-1 infection. Ann Neurol1990;28:556–60.
62.
FerreiraAVillarMLAlvarez-CermenoJCQuantification of soluble serum HLA Class I antigens in healthy volunteers and AIDS patients. Clin Chim Acta1988;174:207–12.
63.
Alvarez-CermenoJCCassadoCVillarLMSoluble Class I antigens (sHLA) in CSF and serum of patients with HIV infection. Acta Neurol Scand1990;82:14–6.
64.
Alvarez-CermenoJCEchevarriaJMVillarLMLazaroIBootelloAGonzales-PorqueP.Soluble Class I antigens in serum and CSF of patients with varicella-zoster virus meningitis. J Neurol Neurosurg Psychiatr1989;52:1194–6.
