Local immunoglobulin synthesis and blood-brain barrier assessment in subacute sclerosing panencephalitis

The immunoglobulin synthesis within the central nervous system and the blood-brain barrier (BBB) function were evaluated in 6 patients with subacute sclerosing panencephalitis (SSPE) using the IgG index and a graphic method based on serum/CSF albumin, alpha 2-macroglobulin, and IgG quotients. A strong local production of IgG was documented by both methods in all 6 cases of SSPE. Concerning the graphic analysis, the decrease in the serum/CSF alpha 2-macroglobulin ratio disclosed BBB dysfunction in 2 cases of SSPE, suggesting, in the absence of the serum/CSF albumin quotient abnormalities, that a homeostatic mechanism for CSF proteins can cause changes in the CSF protein profile.