Abstract
It is well known that the mechanism regulating exchange between the blood and the central nervous system and spinal fluid is disturbed in all types of meningitis, allowing both normal blood constituents and foreign substances to pass into the spinal fluid (reviewed by Katzenellenbogen 1 ). While a “meningeal stage”has been described in poliomyelitis, the origin of the cells in the subarachnoid spaces appears to be from the perivascular spaces of the medullary substance. This communication will give the results of several tests of the blood central nervous system barrier in experimental poliomyelitis. Such findings have a bearing on specific treatment, since a gross barrier defect would allow free passage of neutralizing substances from blood into the medullary substance and spinal fluid.
Flexner and Amoss 2 while showing that the virus did not regularly pass from the blood to the nervous system, suggested that a defect in the barrier might be of importance in the natural pathogenesis of this disease in man. The failure to find virus-neutralizing substances in the spinal fluid of man during convalescence, 3 although these substances are present in the blood of a large number of human convalescents even during and prior to paralysis, 4 could be explained by an intact barrier. In testing the barrier in experimental poliomyelitis with several types of antibodies, Shaughnessy, Grubb and Harmon 5 showed that none of these substances, except diphtheria antitoxin, passed from the blood into either the spinal cord or the spinal fluid. In the clinic, Flatau 6 found the barrier impermeable to acid fuchsin. The value of this latter observation is not great as the stage of the disease was not stated.
Get full access to this article
View all access options for this article.