Intrathecal synthesis of specific antibodies in patients with invasion of the central nervous system by Mycoplasma pneumoniae

Mycoplasma pneumoniae commonly causes respiratory tract infections in human s, but it may also be associated with central nervous system manifestations . The aim of the present study was to determine whether the cerebrospinal f luid taken from patients with neurologic symptoms due to Mycoplasma pneumon iae infection contains specific antibodies and whether the detection of the se antibodies can be used for diagnosis. Mycoplasma pneumoniae was isolated from the cerebrospinal fluid taken from nine patients with central nervous system symptoms on admission to the hospital. In addition, Mycoplasma pneu moniae was detected in cerebrospinal fluid using polymerase chain reaction in four other patients. Antibodies to Mycoplasma pneumoniae were detected u sing the enzyme immunosorbent assay, indirect immunoperoxidase assay and im munoblotting in cerebrospinal fluid samples from 14 of 19 patients included in the study. The indirect immunoperoxidase assay showed high titers of My coplasma pneumoniae immunoglobulin G(1) (IgG(1)) and IgM antibodies in cere brospinal fluid samples of some patients with meningoencephalitis or mening itis. Titers of specific IgA, IgG(2) and IgG(3) antibodies were lower, whil e specific IgG(4) was not detectable. Cerebrospinal fluid samples with high er antibody titers also contained IgA, IgG(1), IgG(2), IgG(3) and IgM antib odies that recognized the P1 adhesin (170 kDa protein) of Mycoplasma pneumo niae. A comparison of antibody titers of concomitant serum/cerebrospinal fl uid samples to Mycoplasma pneumoniae and those to measles virus by enzyme i mmunosorbent assay suggested the intrathecal synthesis of IgG and IgM antib odies to Mycoplasma pneumoniae in patients with acute meningoencephalitis. Data from this study clearly reinforce previous findings that Mycoplasma pn eumoniae is an etiologic agent of central nervous system infections in huma ns.