Željka Vogrinc [1]

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Seventeen years after the first edition, professor E.J. Thompson published the second edition of ‘Proteins of the cerebrospinal fluid’. Compared to other books covering the topic of proteins in CSF, this one is written more from the biochemical and less from clinical point of view.
The major part of the book is dedicated to immunoglobulins in cerebrospinal fluid, particularly to detection and significance of oligoclonal immunoglobulins, while all other proteins are not covered extensively.
The book is divided in four parts. The first part deals with proteins normally present in cerebrospinal fluid, their origin, crossing of barriers and serum concentration ratios. A separate chapter is dedicated to advantages and disadvantages of quantitative versus qualitative methods in protein analysis, with particular emphasis on immunoglobulins.
The second part of the book covers in detail the mathematical models used for evaluating the origin of IgG in cerebrospinal fluid. The author postulates that serum/CSF albumin and IgG ratio is the biologically most suitable parameter in evaluating normal barrier function. For beginners in CSF diagnostics, useful information can be found, e.g. on diurnal variations in CSF secretion, with six-fold increase during night hours.
The third part of the book could serve as a manual for differential diagnostics of particular neurological disorders. The emphasis is again on methods available for detection of oligoclonal immunoglobulins, as well as on detection of antigen specific antibodies or their specific indexes. Other “non immunoglobulin” proteins are covered in detail, with general conclusion being that most “nerve specific” proteins, once considered potential diagnostic markers (such as myelin basic protein), have not fulfilled the expectations and could be used only as prognostic markers.
The fourth part of the book is actually a small laboratory manual which describes in detail the protocols for CSF protein identification using various electrophoretic techniques. It also deals with common problems that occur with these laboratory methods. This fact gives added value to the book, since author’s comments and suggestions are clearly the consequence of years of experience in the field.
The book has an impressive reference list (1322 items!) with separated alphabetic reference list for particular items, which serves as a great information source for anyone who is entering the field of CSF proteins, particularly immunoglobulins.