Fibronectin in plasma and CSF: Evidence for its intrathecal synthesis

!!9 FIBRONECTIN IN P L A S M A AND CSF : EVIDENCE FOR ITS INTRATHECAL SYNTHESIS A.Gervais, E.Schuller Laboratoire de Neuroimmunologie (INSERM U 134) H6pital de la Saip~ri~'re, Paris - France. A new methodology, using electroimmunodiffusion, has been described for :];e, determination of fibronectin (Fn) in plasma and CSF. Fn was determined in the plasma of 35 normal subjects, and in the plasma and the CSF of 86 patients : 10 controls, 17 definite MS, 15 other inflammatory processes, 11 degenerative diseases, 13 peripheral neuropathies and 20 other neurological diseases. The normal mean was 354 -+53 pg/mL in plasma, not influenced by sex or age, and in the CSF 2,3 +-0,85 pg/mL. A significant in~zease of plasma Fn was observed in each of the patients- groups. In the CSF an increase of Fn was observed predominantly in hdlammatory processes but not in MS. An intrathecai synthesis of Fn was established in 24/76 patients, most often in inflammatory (9/15) processes but rarely (3/17) in MS. This intrathecal synthesis was suspected from the CSF Fn/CSF Albmain ratio and calculated using a formula derived from the principles previously described for IgG intrathecal synthesis. It represents the principal source of Fn increase in the CSF. i,~ all inflammatory processes (including MS) the eventual influence of corticoids, immunosuppresive or anti-inflammatory drugs has not been established. The significance of the CSF Fn level in MS is discussed with regard to the recent demonstration of its presence within MS lesions and on macrophages in plaques.

SUPPRESION OF IHTRATHECAL IgG SYNTHESIS DURING THE TREATMENT O F .MULTIPLE SCLEROSIS M. W e n d e r and G. Michalowska-Wender Department of Neurology, School of Medicine, Poznan, Poland The majority of multiple sclerosis/MS/patients produces an excess of IgG in central nervous systems evidenced by the increased IgG level and index in CSF. Therefore the goal of effective therapy should be the suppression of IgG synthesis. The last problem we have studied in course of various therapeutic trials, influencing the immunological processes. Immunological studies were correlated with the clinical status of multiple sclerosis patients. In our clinico-immunological trial we have compared the effect of high doses of Prednisune, ACTH alo:le, ACTH and Cyclophosphamide, and alternate Prednisone and Levamisol therapy ov inL~athecalIgG synthesis. The lgG, and albumin level in CSF and serum was establishP-I using Mancini test. From the results IgG index was calculated. We have found that only the ~re~tment with high doses of Prednisone is effective in suppression of intrathecal lgG synthesis, but without clear cut correlation between this immunological effect of the therapy and clinical results of the treatment. We could also not establish any correlation between the clinical status, duration of the disease or its progres,~ and intrathecal IgG production.