Intrathecal Activation as a Typical Immune Response within the Central Nervous System in Angiostrongyliasis

Barbara Padilla-Docal Central Laboratory of Cerebrospinal Fluid, Faculty of Medical Sciences Dr. Miguel Enriquez, Havana Medical Sciences University, Havana, Cuba

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Ivonne Iglesias-González Central Laboratory of Cerebrospinal Fluid, Faculty of Medical Sciences Dr. Miguel Enriquez, Havana Medical Sciences University, Havana, Cuba

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Raisa Bu-Coifiu-Fanego Central Laboratory of Cerebrospinal Fluid, Faculty of Medical Sciences Dr. Miguel Enriquez, Havana Medical Sciences University, Havana, Cuba

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Carmen Aleida Socarrás-Hernández Central Laboratory of Cerebrospinal Fluid, Faculty of Medical Sciences Dr. Miguel Enriquez, Havana Medical Sciences University, Havana, Cuba

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Alberto Juan Dorta-Contreras Central Laboratory of Cerebrospinal Fluid, Faculty of Medical Sciences Dr. Miguel Enriquez, Havana Medical Sciences University, Havana, Cuba

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Angiostrongylus cantonensis is a zoonotic pathogen that occasionally causes human angiostrongyliasis; its main clinical manifestation is eosinophilic meningitis. This report defines the concept of intrathecal activation of complement as evidence of intrathecal synthesis of major immunoglobulins during this disease. Details are presented of the activation of complement system components in cerebrospinal fluid, and their application to our understanding of this tropical disease, which is emerging in the Western hemisphere. Intrathecal synthesis of at least one of the major immunoglobulins and a wide spectrum of patterns may be observed. Although intrathecal synthesis of C3c is always present, C4 intrathecal synthesis does not occur in every patient. The diversity of intrathecal synthesis and activation of the different complement pathways enables their division into three variant groups (A, B, and C). Variant group A includes the classical and/or lectin pathway and involves two or more major immunoglobulins with C3 and C4 intrathecal synthesis. Variant group B involves C4 in cerebrospinal fluid that comes from blood in the intrathecal activation of the classical pathway. Variant group C includes the alternative pathway.

Author Notes

* Address correspondence to Barbara Padilla-Docal, Ramon Pinto 202, Luyanó, Havana 10700, Cuba. E-mail: barbara.padilla@infomed.sld.cu

Authors' addresses: Barbara Padilla-Docal, Ivonne Iglesias-González, Raisa Bu-Coifiu-Fanego, Carmen Aleida Socarrás-Hernández, and Alberto Juan Dorta-Contreras, Facultad de Ciencias Médicas Dr. Miguel Enríquez – Investigaciones, Ramón Pintó 202 Luyanó, Havana 10700, Cuba, E-mails: barbara.padilla@infomed.sld.cu, iiglesias@infomed.sld.cu, raisabu@infomed.sld.cu, carmen.hdez@infomed.sld.cu, and dorta@infomed.sld.cu.

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