Immunological and serological profiles in subacute sclerosing panencephalitis: insights from igg and igm analysis in cerebrospinal fluid
Abstract
Background. Subacute sclerosing panencephalitis (SSPE) is a progressive neurodegenerative disor- der caused by persistent measles virus infection. Immunological and serological changes, particularly the presence of measles-specific IgG and IgM in cerebrospinal fluid (CSF) and serum, play a critical role in diagnosis and disease progression.
Materials and methods. This study analyzed IgG and IgM levels in the CSF and serum of 45 SSPE patients (32 males, 13 females) using enzyme-linked immunosorbent assay (ELISA). A systematic review of PubMed, Scopus, and Google Scholar was conducted to compare findings with existing literature. Statistical correlations between immunoglobulin levels and patient characteristics were evaluated.
Results. IgG levels remained consistently elevated across all patients, while IgM levels varied signif- icantly. A weak correlation between IgG and IgM was observed, suggesting independent immune response mechanisms. Comparisons with previous studies confirmed the role of intrathecal IgG production and measles-specific antibody presence as key diagnostic markers.
Conclusion. The findings support the clinical utility of IgG and IgM profiling in SSPE diagnosis. While IgG is a stable diagnostic marker, IgM variability may indicate ongoing immune activation. Further research is needed to explore immunogenetic factors influencing disease progression.
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List of references
A. Visudtibhan, P.D. Mehta, J. Kulczycki, Patricia K. Coyle, H Thormar. (2009). Intrathecal production of measles-specific IgA in subacute sclerosing panencephalitis. Acta Neurologica Scandinavica, 96(2), 97–100. https://doi.org/10.1111/J.1600-0404.1997.TB00247.X
Ankkita Sharma Bhandari, Laxmi Khanna, Praveen Kumar, Mandaville Gourie-Devi. (2024). Subacute sclerosing panencephalitis with a fulminant course: Case series. Current Medicine Research and Practice, 14(4), 174–177. https://doi.org/10.4103/cmrp.cmrp_28_24
Kapoor, D., Kakkar, V., Narayana, Y. V., Garg, D., Mukherjee, S. B. (2022). Subacute Sclerosing Panencephalitis in Indian Children Under 5 Years during the COVID Pandemic: A Paradigm Shift in the Clinical Profile. Indian Pediatrics Case Reports, 2(3), 139–144. https://doi.org/10.4103/ipcares.ipcares_ 155_22
Mark P. Burgoon, Gregory P. Owens, Tracey Smith-Jensen, David H. Walker, Donald H. Gilden. (1999). Cloning the Antibody Response in Humans with Inflammatory Central Nervous System Disease: Analysis of the Expressed IgG Repertoire in Subacute Sclerosing Panencephalitis Brain Reveals Disease-Relevant Antibodies That Recognize Specific Measles Virus Antigens. Journal of Immunology, 163(6), 3496–3502.
Mohammad Mahbubul Alam, Nasira Khatoon, Razia Sultana, S. R. Hoque, Enamul Karim, Susanta Kumar Ghosh. (2024). Sub acute sclerosing panencephalitis (SSPE): A Rare Aftermath of Measles in Children. 20(1), 76–80. https://doi.org/10.3329/jmcwh.v20i1.77166
P. D. Mehta, A. Kane, H. Thormar. (1977). Quantitation of Measles Virus-Specific Immunoglobulins in Serum, CSF, and Brain Extract from Patients with Subacute Sclerosing Panencephalitis. Journal of Immunology, 118(6), 2254–2261.
P YenturSibel, GursesCandan, DemirbilekVeysi, Adin-CinarSuzan, KuruUmit, UysalSerap, YapiciZuhal, YilmazGülden, CokarOzlem, OnalEmel, GökyigitAysen, Saruhan-DireskeneliGüher. (2014). A de- crease of regulatory T cells and altered expression of NK receptors are observed in subacute sclerosing panencephalitis. Viral Immunology, 27(10), 506–511. https://doi.org/10.1089/VIM.2014.0070
Pinar Samlioglu, Aycan Ünalp, Ahmet Gökçay, Imre Altuglu, Aysel Öztürk, Aysin Zeytinoglu. (2012). [Subacute sclerosing panencephalitis cases diagnosed by increased CSF/serum measles antibody indices]. Mikrobiyoloji Bulteni, 46(4), 716–718.
R Ts Bembeeva, E.L. Usacheva, S.V. Piliya, E. S. Ilyina, A. K. Shakaryan, A.S. Kozlovskiy, L. M. Kolpakchi, A A Kozyreva, I.D. Fedonyuk. (2024). Subacute sclerosing panencephalitis in children: Series of clinical case reports. Pediatrics, 103(6), 149–160. https://doi.org/10.24110/0031-403x-2024-103-6-149-160
Ruzica Kravljanac Biljana Vucetic Tadic. (2023). Subacute sclerosing panencephalitis: Changes in phenotype during the last decade. Medicinska Istraživanja, 56(1), 37–43. https://doi.org/10.5937/medi55- 41280
S. A. Sulaiman, Nilofar M Vora, Kusumita Chhabra, Muhammad Arsalan Bashir, Zainab Awan. (2024). Pediatric Subacute Sclerosing Panencephalitis: A Narrative Review on Measles and the Future of Vacci- nation. Journal of Child Neurology, 8830738241238860–8830738241238860. https://doi.org/10.1177/08 830738241238860
S. Nath, Kanai Lal Barik, Abu Obayed, Sumanta Laha, Sayan Bera. (2023). Atypical early presentation of subacute sclerosing panencephalitis in children: A case series. Asian Journal of Medical Sciences, 14(8), 262–265. https://doi.org/10.3126/ajms.v14i8.51866
Shaligram, R., Garud, B. P., Jadhav, R. S., Chalipat, S., Mane, S. (2024). A Rare Case of Subacute Sclerosing Panencephalitis in an Immunized Patient. Cureus. https://doi.org/10.7759/cureus.63258
Stefka Krumova, Ivona Andonova, Radoslava Stefanova, Galina Nenkova, Petia Genova-Kalou. (2022). Measles Virus and Subacute Sclerosing Panencephalitis. Clinical Laboratory, 68 9. https://doi.org/10.775 4/Clin.Lab.2021.211147
Suhayl S. Dhib-Jalbut, Alexander M. Abdelnoor, Fuad S. Haddad. (1981). Cellular and humoral immunity in subacute sclerosing panencephalitis. Infection and Immunity, 33(1), 34–42. https://doi.org/10.1128/ IAI.33.1.34-42.1981
Sulaiman, S. A., Vora, N. M., Chhabra, K., Bashir, M. A., Awan, Z. (2024). Pediatric Subacute Sclerosing Panencephalitis: A Narrative Review on Measles and the Future of Vaccination. Journal of Child Neurology, 39(3–4), 89–97. https://doi.org/10.1177/08830738241238860
Yohei Kume, Ken Hashimoto, Kei Iida, Hajime Maeda, Kyohei Miyazaki, Takashi Ono, Mina Chishiki, Yuichi Suzuki, Hayato Go, Kazuhide Suyama, Mitsuaki Hosoya. (2022). Diagnostic reference value of antibody levels measured using enzyme immunoassay for subacute sclerosing panencephalitis. Microbiology and Immunology, 66(9), 418–425. https://doi.org/10.1111/1348-0421.13017
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