IgG subclass deficiency in amyotrophic lateral sclerosis

Mycotoxins causing amyotrophic lateral sclerosis

Amyotrophic Lateral Sclerosis (ALS) remains a terminal disease without an established etiology for the majority of patients. The dominant theory of ALS before the 1970's was the presence of a poison. One of the primary means of treating patients with a toxic exposure has been plasma exchange, but plasma exchange of ALS patients failed to alter the clinical course. The failure of plasma exchange assumes the patient is no longer exposed to the poison. If the exposure to poison continued, then plasma exchange alone would fail. I found laboratory evidence of a poisoning in every patient with ALS examined. A search for specific poisons found evidence of mycotoxins. Treatment with antifungal agents corrected the laboratory findings. All of the ALS patients had evidence of immune suppression. There is mounting evidence that many mycotoxins cause both neurotoxicity and immune suppression. These mycotoxins may be able to explain the full spectrum of pathology in ALS without a secondaryevent.

Routes of stem cell administration in the adult rodent

Stem cell transplantation to replace damaged tissue or correct metabolic disease holds the promise of helping a myriad of human afflictions. Although a great deal of attention has focused on pluripotent stem cells derived from embryos, adult stem cells have been described in a variety of tissues, and they likely will prove to be as beneficial as embryonic stem cells in cell replacement therapy and control of inbred errors of metabolism. We describe methods by which stem cells can be introduced into the nervous system, although the techniques are applicable to any portion of the body to be targeted or any cell that may be used for cell therapy. The first and most straight-forward method is introduction of stem cells directly into the brain parenchyma. The second, which in our hands has proven to be superior in some instances, is introduction of the stem cells into the circulatory system.

Increased concentration of C4d complement protein in CSF in amyotrophic lateral sclerosis

Plasma and CSF concentrations of C4d and the circulating immune complex to C1q were measured in 27 patients with amyotrophic lateral sclerosis (ALS) or cervical spondylosis. There was no significant difference among groups in plasma C4d or in plasma or CSF concentrations of the circulating immune complex to C1q. The ALS group, however, had a significantly higher CSF concentration of C4d than the group with cervical spondylosis, as well as a higher C4d index (CSF to plasma C4d ratio x serum to CSF albumin ratio). These results suggest that augmented complement activation in the CNS occurs in ALS. Increased CSF concentration of C4d or raised C4d index may serve as a basis for differentiating ALS from cervical spondylosis.

Immunoglobulin-G isotype changes in human sporadic amyotrophic lateral sclerosis (ALS)

Out of 50 patients with sporadic amyotrophic lateral sclerosis (sALS), excluding 8 patients with recent immunosuppressive medication or low total IgG, we examined all available 92 sera of 11 women and 31 men nephelometrically for serum immunoglobulin concentrations including IgG isotypes IgG1-4. Mean serum levels of IgA and IgM remained within references in all cases. Isotypes IgG1 and IgG3 were the most frequently altered immunoglobulins. Without specific treatment, 34 out of 42 patients (= 80%) and 58 out of 92 sera (= 63%) demonstrated low IgG3 concentrations (< 0.41 g/l), while 14 patients (= 33%) and 20 sera (= 22%) demonstrated low IgG1 serum levels (< 4.22 g/l). In patients with normal total IgG, isotypes IgG1 and IgG2 often changed in a complementary way, and IgG1/IgG2 serum concentrations correlated significantly (rs = -0.518, P < 0.001). In four longitudinally monitored patients, the IgG3 isotype ranged from 1.3% to 8.2% of serum IgG and demonstrated a remarkable individual variability over time, corresponding to the relatively short half-life of IgG3. Since elevated circulating immune complexes may fluctuate rapidly, altered serum immunoglobulin isotypes could become more convenient parameters in a still enigmatic disease. To assess their role and relevance, their association with clinical course, cerebrospinal fluid and circulating immune complexes has to be examined.