Reibergram of Intrathecal Synthesis of C4 in Patients with Eosinophilic Meningitis Caused by Angiostrongylus cantonensis

Padilla-Docal, Bárbara; Dorta‐Contreras, Alberto Juan; Bu-Coifiu-Fanego, Raisa; Rodríguez-Rey, Alexis; Gutiérrez-Hernández, Juan Carlos; Paula-Almeida, Susana Olga de

doi:10.4269/ajtmh.2010.09-0651

Cited by 6 publications

(6 citation statements)

References 23 publications

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“…A value above this line on the Reibergram indicates the presence of intrathecal IgG synthesis. 25 , 26 This is useful for estimating the intrathecal synthesis for the total IgG level. After estimation of the intrathecal synthesis for each specific antibody, the value of the AI calculated by the following equation can be referenced: …”

Section: Methodsmentioning

confidence: 99%

Difference in the Source of Anti-AQP4-IgG and Anti-MOG-IgG Antibodies in CSF in Patients With Neuromyelitis Optica Spectrum Disorder

et al. 2021

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ObjectiveTo elucidate the differences in the source and in the level of intrathecal synthesis between anti-aquaporin-4 antibodies (AQP4-IgG) and anti-myelin oligodendrocyte glycoprotein antibodies (MOG-IgG).MethodsThirty-eight patients with MOG-IgG-associated disease and 36 with AQP4-IgG-positive neuromyelitis optica spectrum disorders (NMOSD) were studied for the antibody titers in the sera and cerebrospinal fluids (CSF) simultaneously collected in the acute attacks. The quotients between CSF and serum levels of albumin, total IgG, and each disease-specific antibody were calculated. Intrathecal production level in each disease-specific antibody was evaluated by calculating antibody index from these quotients.ResultsEleven of the 38 patients with MOG-IgG were positive for the antibody only in the CSF, while no patient with AQP4-IgG showed CSF-restricted AQP4-IgG. Blood-brain barrier compromise as shown by raised albumin quotients was seen in 75.0% of MOG-IgG-positive cases and 43.8% of AQP4-IgG-positive cases. Moreover, MOG-IgG quotients were more than 10 times higher than AQP4-IgG quotients (effect size r = 0.659, p < 0.0001). Elevated antibody index (>4.0) was confirmed in 12 of 21 with MOG-IgG, whereas it was seen only in one of 16 with AQP4-IgG (φ = 0.528, p < 0.0001). The CSF MOG-IgG titers (rho = +0.519, p = 0.001) and antibody indexes for MOG-IgG (rho = +0.472, p = 0.036) correlated with the CSF cell counts but not with clinical disability.ConclusionsIntrathecal production of MOG-IgG may occur more frequently than that of AQP4-IgG. This finding implies the different properties of B-cell trafficking and antibody production between MOG-IgG-associated disease and AQP4-IgG-positive NMOSD.

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Section: Methodsmentioning

confidence: 99%

Difference in the Source of Anti-AQP4-IgG and Anti-MOG-IgG Antibodies in CSF in Patients With Neuromyelitis Optica Spectrum Disorder

et al. 2021

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“…As the upstream mechanism of eosinophilia, the Th2-type immune response is important in the recruitment and activation of eosinophils (Yamaguchi et al, 1988;Wang et al, 1989;Sasaki et al, 1993). Besides regulating the function of eosinophils by the recruitment and activation or competitive inhibition of eosinophils, the Th2-type immune response can also damage tissues by complement activation (Shaio et al, 1990;Padilla-Docal et al, 2010). However, at the late stage of infection a large amount of non-specific IgE competitively inhibits the function of eosinophils by binding to the receptor (Seminario et al, 1999).…”

Section: Discussionmentioning

confidence: 99%

“…However, at the late stage of infection a large amount of non-specific IgE competitively inhibits the function of eosinophils by binding to the receptor (Seminario et al , 1999). Besides regulating the function of eosinophils by the recruitment and activation or competitive inhibition of eosinophils, the Th2-type immune response can also damage tissues by complement activation (Shaio et al , 1990; Padilla-Docal et al , 2010). Th2 immune responses have to be regulated to a suitable level to prevent tissue damage.…”

Section: Discussionmentioning

confidence: 99%

The use of albendazole and diammonium glycyrrhizinate in the treatment of eosinophilic meningitis in mice infected withAngiostrongylus cantonensis

Tang

Chen

et al. 2011

J. Helminthol.

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Angiostrongylus cantonensis (A. cantonensis) infection causes eosinophilic meningitis in humans. Eosinophilia and a Th2-type immune response are the crucial immune mechanisms for eosinophilic meningitis. CD4+CD25+ regulatory T cells (Treg) are involved in the pathogenesis of A. cantonensis. Diammonium glycyrrhizinate (DG) is a compound related to glycyrrhizin (GL), a triterpene glycoside extracted from liquorice root. We investigated the curative effects and probable mechanisms of therapy involving a combination of albendazole and DG in BALB/c mice infected with A. cantonensis, and compared these with therapy involving albendazole and dexamethasone. We analysed survival time, body weight, signs, eosinophil numbers, immunoglobulin E (IgE), interleukin-5 (IL-5), and eotaxin concentrations, numbers and Foxp3 expression of CD4+CD25+ Treg, worm recovery and histopathology. The present results demonstrated that the combination of albendazole and DG could increase survival time more efficiently and relieve neurological dysfunction; decrease weight loss, eosinophil numbers, concentrations of IgE, IL-5 and eotaxin, the number and expression of Foxp3 of CD4+CD25+ Treg; and improve worm recovery and histopathology changes in treated animals, compared with the combination of albendazole and dexamethasone. The observations presented here suggest that the albendazole and dexamethasone combination could be replaced by the combination of albendazole and DG.

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“…This IgG + IgA + IgM pattern is reported to be related with the special pathological mechanisms of the different diseases, the time of sampling, and the brain localization of the infection. 19,22 Differentiation in the neuroimmunological patterns found in Ecuadorians and Cubans may be explained by taking into account the parasite-host interaction, survival strategies of the parasite in the environment, defense mechanisms of human hosts, like complement activation, 1,33 and quantity of larvae intake.…”

Section: Resultsmentioning

confidence: 99%

Comparison of Major Immunoglobulins Intrathecal Synthesis Patterns in Ecuadorian and Cuban Patients with Angiostrongyliasis

Padilla-Docal¹,

Dorta‐Contreras²,

Moreira³

et al. 2011

The American Society of Tropical Medicine and Hygiene

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Abstract. Angiostrongylus cantonensis meningitis was first reported in Cuba in 1981, and it was recently reported in South America. The aim of this paper is to evaluate the intrathecal immunoglobulin synthesis patterns from Cuba's and Ecuador's patients with angiostrongyliasis; 8 Ecuadorian patients from two different outbreaks and 28 Cuban patients were studied. Simultaneous blood and cerebrospinal fluid simples were taken. Immunoglobulin (Ig) A, IgM, IgG, and albumin were quantified by radial immunodiffusion. Corresponding Reibergrams were applied. A three-Ig pattern was the most frequent in the two groups, but IgM was presented in all Ecuadorian young mature patients; however, in the Cuban children, only 12 of 28 patients had intrathecal IgM, but about 90% had an IgA and IgG synthesis at time of later puncture. This indicates that, with a larger amount of parasites ingested, clinical symptoms are more severe, and a higher frequency of intrathecal IgM synthesis could be observed. This is discussed as a similarity with the intrathecal IgM synthesis in African trypanosomiasis.

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Reibergram of Intrathecal Synthesis of C4 in Patients with Eosinophilic Meningitis Caused by Angiostrongylus cantonensis

Cited by 6 publications

References 23 publications

Difference in the Source of Anti-AQP4-IgG and Anti-MOG-IgG Antibodies in CSF in Patients With Neuromyelitis Optica Spectrum Disorder

Difference in the Source of Anti-AQP4-IgG and Anti-MOG-IgG Antibodies in CSF in Patients With Neuromyelitis Optica Spectrum Disorder

The use of albendazole and diammonium glycyrrhizinate in the treatment of eosinophilic meningitis in mice infected withAngiostrongylus cantonensis

Comparison of Major Immunoglobulins Intrathecal Synthesis Patterns in Ecuadorian and Cuban Patients with Angiostrongyliasis

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