V. Argentiero

Immune activation in multiple sclerosis: study of IL-2, sIL-2R, and γ-IFN levels in serum and cerebrospinal fluid

Serum and cerebrospinal fluid (CSF) levels of interleukin-2 (IL-2), soluble IL-2 receptor (sIL-2R), and gamma-interferon (gamma-IFN) were measured in multiple sclerosis (MS) patients, human immunodeficiency virus type 1 (HIV-1)-infected patients and normal controls (NC). Increased levels of both IL-2 and sIL-2R were found in MS serum. Moreover, 11 of 50 MS patients showed detectable levels of IL-2 in the CSF. HIV-1-infected patients had increased levels of sIL-2R in serum and, less frequently, in the CSF. gamma-IFN was never detected in serum and CSF of all the patients studied. These findings confirm preliminary reports, further stress a systemic T-cell activation in MS, and support the hypothesis that an immunologic disorder exists in such patients.

Transferrin receptors in rat central nervous system: An immunocytochemical study

Using an immunocytochemical method we demonstrated the presence of TfR on adult rat neurons, particularly in the cerebral cortex and brain stem. The monoclonal antibody (mab) against rat TfR (clone OX 26) stained neurons of all cortical layers and in the brain stem where the reaction was most evident. Purkinje cells in the cerebellum and scattered neurons in the gray matter of the cervical spinal cord were weakly stained. Choroid plexus cells also reacted with the mab against TfR whereas oligodendrocytes in the cerebral white matter were faintly outlined by the mab. The presence of TfR on endothelial cells of brain capillaries was here confirmed.

Anti-gabaergic neuron autoantibodies in a patient with stiff-man syndrome and ataxia

We describe a patient with autoimmune insulin-dependent diabetes whose original symptoms of trunk stiffness and rigidity of the abdomen were followed three years later by a pancerebellar syndrome. An autoantibody (autoAb) against GABAergic neurons was found in the patients serum and cerebrospinal fluid (CSF); on Western blot, this autoAb recognized a 64-kDa antigen of cerebellar protein. The detection of this antibody in a case with ataxia suggests that a spectrum of different neurological diseases may be observed in patients harbouring anti-GABAergic neuron autoAb and supports the concept that factors other than autoAb contribute to the clinical presentation of these disorders.

Immunological indices in presenile Alzheimer's disease

Immunological indices, both T- and B-dependent, were studied in 11 patients affected by presenile Alzheimers disease. The data obtained were compared with those from a group of normal adults of similar age and from a group of normal young subjects. Furthermore, antisera were produced in rabbits against Alzheimers serum and compared to antisera against normal human serum. The following results were obtained: decrease of serum IgM levels; no monoclonal aspects or auto-antibodies were detected in our patients. The kappa/lambda ratio was also normal. The T cell system was functionally normaly, but with a slight decrease of the T cell number and with an increase of the Null lymphocytes. No specific serum proteins were found in the anti-Alzheimer antisera. The data are discussed in correlation to the possible genesis of senile plaques.

Dopamine (DA) and serotonin metabolic levels in the cerebrospinal fluid (CSF) in Alzheimer's presenile dementia under basic conditions and after stimulation with cerebral cortex phospholipids (BC-PL)

SummaryHVA and 5-HIAA levels in CSF were investigated in ten patients with presenile Alzheimers dementia. As reported by others, CSF levels of dopamine and serotonin metabolism are lower in patients with presenile dementia than in normal controls of the same age.After lumbar puncture, the patients were treated with cerebral cortex phospholipids (200 mg i.v. daily). This produced a significant increase in CSF levels of HVA and 5-HIAA, as well as a reduction of serum PL.The data are interpreted as proving an active pharmacological action of cerebral cortex phospholipids on the various processes of the neurotransmitter substances in demential syndromes.ZusammenfassungEs wurde bei zehn Patienten mit praseniler Alzheimer Demenz der Gehalt des Liquor cerebrospinalis an Homovanillinsäure (HVA) und 5-Hydroxindolessigsäure (5-HIAA) untersucht.Wie schon andere Autoren mitgeteilt haben, ist der Gehalt an Stoffwechselprodukten von Serotonin und Dopamin im Liquor geringer bei Patienten die an präseniler Demenz leiden als bei normalen Kontrollen gleichen Alters. Nach Lumbalpunktion wurden die Patienten mit Hirnrindephospholipiden behandelt (200 mg/täglich intravenös).Diese Behandlung bewirkte eine nennenswerte Steigerung des Gehaltes an HVA und 5-HIAA im Liquor cerebrospinalis und gleichzeitig eine Senkung der Serumphospholipide.Die Ergebnisse sprechen für eine günstige pharmakologische Bewirkung der Hirnrindephospholipiden auf die verschiedenen Prozesse, an welchen die Transmittersubstanzen in den Demenz-Syndromen teilnehmen.

Macrophage-colony stimulating factor (M-CSF) in the cerebrospinal fluid

In a series of 145 cases with neurological diseases, macrophage-colony stimulating factor (M-CSF) was detected in cerebrospinal fluid of patients with brain tumors, bacterial meningitis, and less frequently, AIDS-dementia complex. Granulocyte-colony stimulating factor (G-CSF) was found only in patients with bacterial meningitis; granulocyte-macrophage (GM)-CSF was never detected. These findings suggest that M-CSF may play an important intrathecal immunoregulatory role in neoplastic and infectious diseases of the central nervous system.

Lead Polyneuropathy of Nonindustrial Origin

A case of a subacute, distal, symmetrical polyneuropathy in a housewife is reported. The fact that the polyneuropathy affected almost only the motor fibers led us to suspect an exogenous intoxication. Blood lead level and the urinary excretion of lead after intravenous EDTA very high. The blood lead levels were normal in the husband and children oif the patient. A glazed cup used only by the patient to keep tea with lemon juice was found to release toxic amounts of lead with acidic solutions. The manufacturer of the cup was not identified by the enquiring authorities and therefore almost certainly other lead-releasing cups are still in use. The importance of suspecting lead intoxication in individuals not professionally exposed is stressed.

Growth factor (M-CSF) and antigenic properties of macrophages in meningioma

SummaryIn meningiomas, transformed meningeal cells can share morphological aspects (in hemangiopericytic meningioma) and antigenic properties (i.e.: HLA-DR antigens expression) with elements of the monocyte/ macrophage lineage. In this report, we describe a case of a highly vascular meningioma where numerous tumor cells, studied with immunohistochemical methods, present phenotypic properties of macrophages. Moreover, the cerebrospinal fluid (CF) analysis disclosed, using a biological assay, a high level of a growth factor for monocytic elements, the Macrophages Colony Stimulating Factor (M-CSF). Our findings may confirm that transitional aspects between different mesenchymal cells could be present in meningiomas.

Spinal cord herniation: a missing piece in the pathogenesis of amyotrophic lateral sclerosis and multiple sclerosis?

Background: Idiopathic spinal cord herniation (SCH) is a rare and often misdiagnosed condition characterized by displacement of the spinal cord through an anterior defect of the dural sac. This condition determines continuous focal trauma of the spinal cord, causing slowly progressive myelopathy. The peculiar MR scan findings, particularly sagittal T2-weighted images, allow its recognition. Objective: Herein, we report 3 cases of SCH and suggest a possible association with trauma-related neurodegenerative or chronic inflammatory diseases. Methods: We reviewed the clinical files of all patients admitted to our hospital with a history and signs of progressive myelopathy (paraparesis and/or lower extremity hypoesthesia) who were diagnosed with SCH by MRI. Results: We found 3 female patients (37, 69 and 68 years of age) with a diagnosis of SCH. Two of them presented with concomitant, relatively rare disabling neurological diseases, namely amyotrophic lateral sclerosis and multiple sclerosis. The third patient underwent surgery and gradually recovered over 6 months. Conclusions: Persistent central nervous system trauma due to idiopathic SCH might provide an unexpected hint about the pathogenesis of amyotrophic lateral sclerosis and multiple sclerosis.