CSF/serum quotient graphs for the evaluation of intrathecal C4 synthesis

doi:10.1186/1743-8454-6-8

Cerebrospinal Fluid Research

Volume 6

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Padilla-Docal B
Dorta-Contreras AJ
Bu-Coifiu-Fanego R
Rey AR

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Rey AR
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Research

CSF/serum quotient graphs for the evaluation of intrathecal C₄synthesis

Barbara Padilla-Docal , Alberto J Dorta-Contreras , Raisa Bu-Coifiu-Fanego and Alexis Rodriguez Rey

Central Laboratory of Cerebrospinal Fluid (LABCEL) Faculty of Medical Sciences "Dr Miguel Enriquez" Superior Institute of Medical Sciences of Havana AP 10049, 11000 CP Havana City, Cuba

author email corresponding author email

Cerebrospinal Fluid Research 2009, 6:8doi:10.1186/1743-8454-6-8


Published:	2 July 2009

Abstract

Background

Cerebrospinal fluid (CSF)/serum quotient graphs have been used previously to determine local synthesis in brain of immunoglobulins and C₃complement component. The aim of this study was to use the same technique to construct quotient graphs, or Reibergrams, for the beta globulin C₄and to evaluate the method for assessing intrathecal synthesis in neurological disease.

Methods

The constants in the previously-defined Reibergram for immunoglobulin IgA were used to calculate the CSF/serum quotient for C₄. CSF and serum were analyzed for C₄, IgA and albumin from a total of 12 patients with meningoencephalitis caused by encapsulated microorganisms and 10 subjects without infections or inflammatory neurological disease, some of which had dysfunction of the blood-CSF barrier,

Results

The formula and C₄Reibergram with the constants previously found for IgA, determined the intrathecal C₄synthesis in CSF. The intrathecal C₄fraction in CSF (C₄loc in mg/l) was compared to the C₄-Index (fraction of CSF: serum for C ₄/fraction of CSF: serum for albumin). There was a significant correlation between the two formulae. The CSF/Serum quotient graph was superior for detecting intrathecal synthesis of C₄under variable conditions of blood-CSF barrier permeability.

Conclusion

The C₄Reibergram can be used to quantify the intrathecal synthesis of this component of the complement system in different infectious diseases of the central nervous system and is especially useful for patients with blood-brain barrier dysfunction.