Cerebrospinal fluid (CSF) of 70 patients with Alzheimer''s disease (AD) and 36 age-matched healthy controls was examined for signs of immunological abnormality. In healthy adults, the CSF cytological picture was dominated by small lymphocytes and monocytes, together accounting for about 98% of cells. There were no changes related to sex or age in the cell composition. In the AD group, there was an increased percentage of monocytes compared with controls, but with great overlap between groups. Five AD patients displayed intrathecal synthesis of IgG, without a concomitant increase in the number of leukocytes, or a change in the cytological picture. This study shows that there is no major change in the cell-mediated immune system in AD. The discrete disturbance in the CSF cytological picture in AD may be a secondary phenomenon related to the cerebral degeneration.

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