Cerebrospinal fluid lysozyme and β2-microglobulin in neurosarcoidosis

doi:10.1016/0022-510X(86)90066-3

Journal of the Neurological Sciences

Volume 73, Issue 1, March 1986, Pages 79-87

https://doi.org/10.1016/0022-510X(86)90066-3 Get rights and content

Abstract

The levels of lysozyme (LZM) and β₂-microglobulin (β₂m) were measured in the cerebrospinal fluid (CSF) and serum of 32 patients with sarcoidosis, 20 of whom had neurosarcoidosis. LZM was analyzed by a new radioimmunoassay (RIA) modification. CSF LZM was elevated in 15 of 20 patients with neurosarcoidosis but in only 4 of 12 patients with extraneural sarcoidosis. CSF β₂m values were elevated in 13 of 19 and in one of 11 patients, respectively. In neurosarcoidosis, both CSF LZM and β₂m correlated to CSF leucocytes but not significantly to CSF albumin thus suggesting that LZM and β₂m were secreted from cells within the central nervous system (CNS). In patients with sarcoidosis, elevations of CSF LZM and β₂m revealed disease activity in the CNS. Both analyses were also useful in the follow-up of neurosarcoidosis.

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La β2-microglobuline (β2-M) est un polypeptide de faible masse moléculaire (11 800 Da) qui existe sous une forme libre et une forme liée aux membranes des cellules (chaîne légère des molécules HLA de classe I). Ce polypeptide joue un rôle important dans les défenses immunitaires ainsi que dans la prévention contre l’apparition des cellules cancéreuses. Ce travail se propose de montrer l’intérêt du dosage de la β2-M dans différents milieux biologiques avec une mise au point sur les principales techniques de dosage. On terminera par les perspectives de son utilisation comme marqueur dans d’autres domaines.
La β2-M est présente dans de nombreux liquides biologiques dont le sang, les urines, le liquide céphalo-rachidien (LCR) et les dialysats. Les méthodes de dosage de la β2-M sont des techniques immunochimiques: chimiluminescence, turbidimétrie et la technique RIA (radio-immunoassay). Les valeurs usuelles sont comprises entre 1,1 à 2,4 mg/L dans le sang, 0,8 à 1,8 mg/L dans le LCR, < 0,37 mg/24 h ou < 0,28 mg/g de créatinine dans les urines.
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Citation Excerpt :
CSF abnormalities in neurosarcoidosis are usually non-specific and include mild pleocytosis, high protein content, and, sometimes, slightly low glucose concentrations. Furthermore, increases in the concentration of ACE,118–124 IgG-index,125–127 oligoclonal bands,9,125,126 CD4/CD8 lymphocyte ratios,128 and lysosyme and β2-microglobulin concentrations129 in CSF have been reported. About a third of patients with neurosarcoidosis have normal CSF.11,21,103
Sarcoidosis is an inflammatory multisystem disorder of unknown cause. Practically no organ is immune to sarcoidosis; most commonly, in up to 90% of patients, it affects the lungs. The nervous system is involved in 5–15% of patients. Neurosarcoidosis is a serious and commonly devastating complication of sarcoidosis. Clinical diagnosis of neurosarcoidosis depends on the finding of neurological disease in multisystem sarcoidosis. As the disease can present in many different ways without biopsy evidence, solitary nervous-system sarcoidosis is difficult to diagnose. Corticosteroids are the drug of first choice. In addition, several cytotoxic dugs, including methotrexate, have been used to treat sarcoidosis. The value of new drugs such as anti-tumour necrosis factor α will be assessed. In this review we describe the clinical manifestations of neurosarcoidosis, diagnostic dilemmas and considerations, and therapy.
Cerebrospinal fluid β<inf>2</inf>-microglobulin in neuro-Behcet's syndrome
2000, Journal of the Neurological Sciences
Paired serum and cerebrospinal fluid (CSF) specimens from 17 patients with Behçet’s disease and central nervous system (CNS) involvement (neuro-Behçet’s syndrome; NB) were studied for β₂-microglobulin (β₂MG) and albumin, using ELISA and single radial immunodiffusion, respectively. We also studied 29 patients with non-inflammatory neurological diseases for comparison. All of CSF β₂MG, serum β₂MG, Q albumin (an indicator of blood–brain barrier function), and CSF β₂MG index (an indicator of intrathecal β₂MG synthesis) were significantly elevated in patients with NB compared with the control patients. There were no significant differences in these parameters between 11 patients with chronic NB and six patients with acute NB. In nine patients with NB, CSF β₂MG and Q albumin were significantly decreased when the CNS manifestations were improved by successful treatment, whereas CSF β₂MG index and serum β₂MG were not significantly changed. The results indicate that the elevation of CSF β₂MG, which results from the transudation of serum β₂MG as well as the increased intrathecal synthesis presumably by infiltrating lymphocytes, is a good marker of CNS disease activity of NB. The data, however, also suggest that the intrathecal synthesis of β₂MG might not parallel to the CNS disease activity of NB, most likely due to the recovery of constitutive physiological intrathecal synthesis of β₂MG in spite of the withdrawal of pathological β₂MG synthesis at times of treatment-associated improvement.

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Cerebrospinal fluid lysozyme and β2-microglobulin in neurosarcoidosis

Abstract

J. Neurol. Sci.

Lancet

Lancet

Lancet

J. Neurol. Sci.

Sarcoidosis of the central nervous system

J. Neurol. Neurosurg. Psychiat.

β2-Microglobulin in haematological malignancies

Brit. Med. J.

The value of the measurement of cerebrospinal fluid levels of lysozyme in the diagnosis of neurological disease

J. Neurol. Neurosurg. Psychiat.

On a remarkable bacteriolytic element found in tissues and secretions

Vermehrtes Auftreten von Lysozym im Liquor und Urin bei Fällen von Meningitis

Klin. Wschr.

The relationship between serum lysozyme levels and the blood leukocytes

Isr. J. Med. Sci.

β2-Microglobulin production by highly purified human T and B lymphocytes in cell cultures stimulated with various mitogens

Immunology

Tissue distribution of lysozyme in man

J. Histochem. Cytochem.

Immunohistochemical demonstration of lysozyme in the lymph nodes and Kveim reaction papules in sarcoidosis

Acta Path. Microbiol. Scand.

Cerebrospinal fluid lysozyme and β₂-microglobulin in neurosarcoidosis

β₂-Microglobulin in haematological malignancies

β₂-Microglobulin production by highly purified human T and B lymphocytes in cell cultures stimulated with various mitogens