SIXTY to seventy percent of patients with multiple sclerosis (MS) have an elevated cerebrospinal fluid (CSF) immunoglobulin G (IgG) in the presence of normal serum IgG.1,2 These results prompted Kabat et al1 to suggest that IgG was synthesized in the brain. The results obtained by Frick and Scheid-Seydel,3 utilizing intravenous perfusion of radioactive IgG and albumin in a variety of patients, also suggested that the elevated CSF IgG in MS patients was derived from brain tissue or its coverings.
Recently we reported4 for the first time that a positive correlation existed between the concentration of IgG in MS brain tissue (plaques of demyelination and surrounding normal-appearing white matter) and the IgG content of the CSF. In subsequent reports5,6 we suggested that the IgG in MS brain tissue was synthesized in the brain rather than derived from the blood because the blood-brain barrier appeared to be
Simpson JF, Tourtellotte WW, Kokmem E, Parker JA, Itabashi HH. Fluorescent Protein Tracing in Multiple Sclerosis Brain Tissue. Arch Neurol. 1969;20(4):373–377. doi:10.1001/archneur.1969.00480100049007
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