Evaluation of the blood-brain barrier in the chronic graft versus host disease

THESES

EVALUATION OF THE BLOOD-BRAIN BARRIER IN THE CHRONIC GRAFT VERSUS HOST DISEASE (Abstract)^*. THESIS. SÃO PAULO, 1997.

SÉRGIO MONTEIRO DE ALMEIDA^**

The central nervous system (CNS) involvement in chronic graft versus host disease (GVHD) has been suggested. Chronic GVHD resembles auto immune connective tissue disorders, which contributes to the hypothesis that immune mediated complications can occur in CNS during chronic GVHD. The blood-brain barrier (BBB) contributes to the CNS immunological isolation. The BBB integrity may contribute to the low frequency of direct involvement of the CNS in GVHD. However, in auto immune connective diseases there is both disruption of BBB and immunoglubulin synthesis in the CNS. The BBB has never been evaluated in patients submitted to bone marrow transplantation (BMT).

This study was done to evaluate BBB integrity and intra BBB immunoglobulin synthesis through the analysis of cerebrospinal fluid (CSF) proteins. Also, the general CSF features were studied. Thirty three CSF and matched serum samples, from chronic myelocytic leukemia (CML) patients who underwent allogeneic BMT from HLA identical related donors, were collected pre BMT, post BMT and during GVHD.

Total CSF cells were increased in cases with chronic GVHD (41.8%), which were not found in non chronic GVHD patients. These cells were mainly lymphocytes, and were not related to infection or relapse of CML.

There were no evidences of BBB disruption or intra BBB immunoglobulin synthesis, and no oligoclonal band were found among patients studied.

KEY WORDS: blood-brain barrier, cerebrospinal fluid, immunoglobulin synthesis, chronic myelocytic leukemia, bone marrow transplantation, chronic graft versus host disease.

**Address: Especialidade Neurologia, Hospital de Clínicas de Curitiba, Universidade Federal do Paraná ­ Rua General Carneiro 181 ­ 80060-900 Curitiba PR ­ Brasil.

*

Avaliação da barreira hemato-encefálica na doença do enxerto contra o hospedeiro crônica (Resumo). Tese de Doutorado, Universidade Federal de São Paulo ­ Escola Paulista de Medicina (Área: Imunologia). Orientador: Eurípedes Ferreira; co-orientador: José Antonio Livramento.

Publication Dates

• Publication in this collection
  17 Nov 2000
• Date of issue
  Mar 1998