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July 1992, Volume 42, Issue 7

Original Article


Kartar Dawani  ( Postgraduate Medical Institute, Lahore. )
Mohammad Tayyab  ( Postgraduate Medical Institute, Lahore. )


Serum of 37 brain tumour patients was studied for, Total pfOtein, Protein electrophoresis, lgG, lgA, and IgM in an attempt to asceftain humoral immune response. Findings were compared with 20 healthy subjects, matched for age, sex and socioeconomic status. There was significant rise in alpha-II globulin, while lgG was suppressed in tumour patients. Decrease of lgG was more marked in patients with malignant tumours. Immunoglobulin A was low in children when compared with adults. Immunoglobulin M remained unchanged (JPMA 42: 157, 1992).


Brain tumours have attracted less attention than other human neoplasms, because of the widely held view that the brain is an immunologically privileged site1. This statement was supported by the evidence of lack of metastasis, which is postulated to being the result of efficient extra cerebral immune surveillance. 2 A study of the inter-relationship between the tumour and the host immune system is important for research in the field of, immunotherapy; so the present work was carried out to fathom any immune response in the sera of brain tumour patients.


Thirty seven ‘patients with brain tumours were chosen for this study from the Department of Neurosurgery, Lahore General Hospital. Selection was based on signs and symptoms of space occupying lesion and later on craniotomy revealed tumours, ratified by histopathology. Serum of all patients was assayed for total protein, protein electrophoresis and IgG, IgA, IgM immunoglobulins. The reference values were derived from 20 healthy subjects matched for age, sex and socioeconomic status. Ml samples were assayed for total protein on same day while immunoglobulins (G,A,M) and protein electrophoresis were done on sera stored at -40k’ C. Immunoglobulin estimation was carried out by Radial Immunodiffusion technique using kits provided by Kal­lasted Laboratories, USA. Electrophoresis was carried out on cellulose acetate membrane on cIvi-70 tank and different protein fractions were quantitatively measured by elvi-165 densitometer. Student \\\'t\\\' test was used for comparison.


Mean levels of total serum proteins, albumin, alpha 1 and gamma globulins were similar in patients and controls Table-I)

except one patient with astrocytoma had high albumin (72.7 g/L) and one with epidermoid cyst had very low (1.8 g/L) gamma globulin levels. Mean values of serum lgG were significantly lower in patients than controls (p< 0.001) (Table-lI)

and in patients with malignant tumours (P <0.05) (Table-III)

when compared with those with benign lesions. The difference in mean serum IgA levels between patients with benign and malignant tumours and be­tween patients and controls was statistically insignificant but the mean values in adult patients were significantly higher (P < 0.01) than in children (Table-IV)

There was no difference in mean values of 1gM in various groups.


Humoral immunity has its role in host tumour interactions3, and changes in different serum proteins in patients with cancer reflect chiefly the reaction of the host to the presence of tumour. Normal total serum protein levels observed in this study and by others5 indicate adequate nutritional status in patients with brain tumours. Protein electrophoresis was normal except for an elevated alpha 2 globulin levels which may be due to an increase in some constituent of alpha 2 band5. Significantly low lgG levels particular in those with malignant tumours observed in this and some previous studies6,7 may be due to immunosuppressive effect of neoplastic process. All our patients were on , steroid therapy which may have contributed to immunosuppres­sion8. Immunoglobulin A was within normal range, but it was significantly low in children (11 cases) when com­pared with adults. The cause for this difference is not clear and needs further evaluation. 1gM levels were normal in this study but both normal and high levels have been reported by other workers5,7. In this study findings of suppressed IgG, more in malignant cases and low IgA in children seems to be due to well known suppressive effect of neoplastic and corticosteroid therapy. The increase of alpha-Il globulin needs further evaluation.


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3. El-Samra, IC, Aboul Enein, M., Hindawy, A.S. et at Study of hunorah response to brain tumour antigens in children.). Egypt, Nati. Cancer Ins., 1986;2:327-34.
4. Let, Y.N. Quantitative changeofserum proteins and immunoglobin patientswith solid cancers.). Surg. Oncol., 1977;9:179-87.
5. Polkowska-Kulebaz, B., Pluzanska, A., Alwaaisk, 3. and Mikuta, M. Immunoglobulins and other serum proteins, T and B lymphocytes and degree of blastic transformation of lymphocytes stimulated by PHA in the brain tumour patients. Neuropathol. Pol,1980;18;139-49.
6. Monad, M., Galvez, S. and Farcas, A. CSF and serum immunogiobuhins and C-S levels in 30 intracranial tumours. Neuocirugia, 1978;36:75-82.
7. Tokumaru, T. and Cataisno, LW. Elevation ofserum immunoglobuhin M (1gM) level in patients with brain tumours. Surg. Neurol., 1975;4:17-21.
8. Mahaley, MS. Jr., Brooks, W.H., Roszman, T.L, Signer, 0.0., Dudka, L and Richardson, S. Immunobiology of primary intracranial tumours. 3. Neurosurg., 1977;46:467-76.

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