CEREBROSPINAL-FLUID COMPLEMENT ACTIVATION IN NEUROLOGICAL DISEASES

Laser nephelometry (LN) is a rapid and very sensitive method for simul taneous determination of albumin, immunoglobulins, C(3)c and C-4 in di luted serum and paired cerebrospinal fluid (CSF) samples. It is very u seful in routine analyses. Determination of C(3)c and C-4 covers class ical as well as alternative pathways of complement activation. In CSF, they are mostly derived from and related to serum values. Under physi ological conditions, the addition of intrathecal C, synthesis is likel y. The incidence of complement activation within CSF is also influence d by the method of choice (native molecules, activation products and c omplexes, inhibitors) and the mode of interpretation of results accord ing to the functional state of the blood-brain barrier (BBB). Calculat ion of indexes and the modified Reiber's graph method are valid means of detection of complement activation within CSF. Complement activatio n within CSF was confirmed in 36% (111/302) of neurological patients e xamined; in 55% (48/87) of patients with inflammatory and demyelinatin g diseases, in 40% (37/94) of patients with CNS infections and complic ations, in 33% (4/12) of patients with motor neuron diseases, in 27% ( 11/40) of patients with spinal cord compression and sequelae, in 25% ( 8/32) of patients with neoplastic disease, and in 17% (6/37) of patien ts with cerebrovascular accidents. (C) 1998 Elsevier Science B.V.