Factors in serum and cerebrospinal fluid from children with viral encephalopathies impair glucose transport.

Since glucose transport appears to be inhibited in viral infections, we looked for inhibitors in cerebrospinal fluid (CSF) and serum of children with febrile convulsions (FC) and Singapore syndrome (SS). When incubated with rat and human adipocytes both fluids from FCs inhibited the utilization of glucose supplied in the medium as exhibited by decreased synthesis of triglycerides. Sera in the acute stage of the illness were more inhibitory than those from convalescents. There was competition between 3-0 methyl glucose and the CSF factors suggesting competitive inhibition at the plasma membrane. This may be due to anti-idiotypic antibodies. The likelihood of a second inhibitor is suggested by (1) the inhibitory activity of the larger of two fractions (about 80,000 molecular weight, corresponding to albumin) obtained in gel filtration chromatography of pooled CSF and (2) failure to observe a decrease in inhibitory activity with recovery from SS following management with hyperglycaemia-producing infusions. These observations are consistent with glycated albumin as a possible factor. Further characterization is called for to ascertain the genesis of viral encephalopathies.