Tibbling, G., Link, H. & Ohman, S. Principles of albumin and IgG analyses in neurological disorders. I. Establishment of reference values. Scand. J. din. Lab. Invest. 37, 385-390, 1977.Protein parameters in CSF and serum have been studied in ninety-three reference subjects. CSF/S albumin ratio is proposed to be superior to CSF-protein or CSF-albumin as a test of the blood-brain barrier function, while IgG-index = (CSF/S IgG ratio)/(CSF/S albumin ratio) is superior to CSF IgG/protein ratio or CSF/albumin ratio for the demonstration of IgG elevation in CSF due to synthesis within CNS. The two quotients recommended correct for variations of albumin and IgG concentrations in serum. When the serum proteins are within reference range, the CSF protein concentrations are mainly regulated by the permeability of the blood-brain barrier, while the influence of S-albumin and S-IgG is only secondarily. The CSF/S albumin ratio is age dependent, while IgG-index is not. A proposed graphical presentation of CSF/S albumin and IgG-index may facilitate the interpretation of these parameters in routine clinical work.

Fifty-nine multiple sclerosis patients were investigated with regard to blood-brain barrier function by determining the CSF-protein and the CSF/S albumin ratio. Abnormal values were found in 19% and 32% respectively. The occurrence of CSF-IgG elevation due to synthesis within the CNS was analysed by determining the CSF IgG/protein and CSF IgG/albumin ratios and the IgG-index = (CSF/S IgG ratio)/(CSF/S albumin ratio). Increased values were found in 75%, 80% and 86%, respectively. Oligoclonal IgG was found in CSF by agarose gel electrophoresis in 88% of the patients. The IgG-index is the parameter recommended for the demonstration of an IgG elevation in CSF due to synthesis within the CNS.

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During 7 weeks in the spring of 1973 a double-blind pilot study on 172 children in the age group 8-9 was carried out to test the possible effect of 1000 mg vitamin C daily as a prophylactic agent against common colds. During the autumn of 1973, a main study was carried out on 642 children of the same age. The investigations had the same pattern and lasted for 3 months. Both studies have been processed on the same principles. The results were somewhat divergent but, like previously published studies on children, seemed to indicate that the duration and severity of the cold were reduced while, on the other hand, the incidence remained unaltered or indeed increased. The total number of days of upper respiratory tract infection was smaller for the vitamin C group only in the pilot study (not in the main study). No proven biochemical effects were obtained. Preventive treatment of healthy children with vitamin C in large doses this had no definitely proved effect against colds.