Adenylate kinase activity of cerebrospinal fluid in central nervous system disorders

Adenylate kinase activity was measured in 41 samples of cerebrospinal fluid in 34 patients with various neurological disorders or psychiatric symptomatologies. Activities of the enzyme showed to be linked to clinically estimated acuteness or progression of the changes in the central nervous system at the time of specimen collection. The findings suggest the conclusion that determination of adenylate kinase activity in cerebrospinal fluid is a meaningful tool for the evaluation of progression and/or acuteness of central nervous system disorders.     

脑脊液循环动力学的初步计算机建模分析

目的 应用磁共振相位对比法和计算流体力学软件对脑脊液循环系统进行数值模拟,分析脑脊液循环的动力学特性,并与临床实际相比较.方法 用磁共振相位对比法测定2例正常人的中脑导水管脑脊液流速,并利用临床磁共振扫描图像建市脑脊液循环系统的数值模型,用Matlab软件及Enguage软件提取脑脊液循环系统的轮廓并进行网格划分,然后应用COMSOL Muhiphysics软件进行脑脊液循环系统数值模拟及脑脊液动力学分析.结果 通过模拟软件能模拟脑脊液循环存在的与心动周期相关的有规律的双向流动,表现为心脏收缩期向足侧流动,舒张期向头侧流动,各时相期计算出的速度与我们用磁共振相位对比法测定的在体速度相一致.同时脑脊液循环系统的数值模型能够计算得到颅内压力梯度、脑和脊髓组织固体应力等.结论 脑脊液循环系统的计算机建模分析能无创性得到脑脊液循环的各项动力学量化指标,计算所得与临床实际相符合.本模型为进一步研究一些中枢系统疾病如交通性脑积水、Chiari畸形、脊髓空洞症等的脑脊液动力学机制奠定了基础.     

中枢神经系统感染性疾病脑脊液检查的临床应用

目前,对于中枢神经系统感染性疾病的诊断仍需依赖脑脊液检查结果,尤其是病原微生物的检查结果。不同炎症反应(包括细菌性、病毒性、肉芽肿性)脑脊液成分特点不同。一般病原微生物培养最具特异性但敏感性较低,实际上,大多数病毒、寄生虫、真菌和慢性细菌性中枢神经系统感染其脑脊液培养常为阴性。血清病原抗体阳性仅能证明体内     

Function of purification drainage of the central nervous system through the cerebrospinal fluid

It has long been known that the cerebrospinal fluid can not be the nervous system lymph, and Mestrezat, in his authoritative book of the year 1912, demonstrated it plainly. Davson has undertaken this subject and suggested the hypothesis of a sink action of cerebrospinal fluid, allowing a slow leakage of solutes from nervous tissue extracellular space. In order to test this hypothesis, Oldendorf and Davson performed a series of animal experiments and they demonstrated that there was leakage of the solute into cerebrospinal fluid. Based on the idea of this sink action of cerebrospinal fluid, some possible physiological implications were considered such as the mechanism of origin of the ventricle-subarachnoid cerebrospinal fluid protein gradient; the mechanism of protection of the central nervous system against the harmful substances of the blood stream; and the homeostatic mechanism whereby the concentration of some ions of the fluid remains constant. Also, it is considered the possibility of a sink action of cerebrospinal fluid in the resolution of brain edema in water intoxication and other types of central nervous system edema.     

Detecting infectious agents in central nervous system inflammation by cerebrospinal fluid analysis

Cerebrospinal fluid analysis is the method of choice in CNS infection and provides the basis for appropriate treatment. Due to the proximity of CSF and CNS, the infectious agent may be detected directly by microscopy or antigen or nucleic acid detection--the latter by polymerase chain reaction--in native CSF or after culture. Furthermore, intrathecal antibody synthesis against the infectious agent may identify the cause of infection. This indirect antigen detection method requires correction for a systemic antibody response and a blood-CSF barrier disturbance. The following text gives an overview of appropriate detection methods and their relevance to the most important CNS infections.     

Distribution of immunoreactive melanin-concentrating hormone in the central nervous system of the rat

The distribution of melanin-concentrating hormone-like immunoreactivity (MCH-LI) in 41 microdissected brain and spinal cord regions was determined using radioimmunoassay with antibodies to salmon MCH. The highest concentration of MCH-LI was detected just ventral to the zona incerta (subzona incerta) (2923.2 fmol/mg protein). Very high concentrations of MCH-LI (greater than 1000 fmol/mg protein) were detected also in the nucleus of the diagonal band, medial forebrain bundle, posterior hypothalamic nucleus and medial mammillary nucleus. High concentrations of the peptide (between 500-1000 fmol/mg protein) were measured in 11 brain regions, including bed nucleus of stria terminalis, paraventricular nucleus, anterior hypothalamic nucleus, median eminence, parabrachial nucleus. Moderate concentrations of MCH-LI (between 250-500 fmol/mg protein) were measured in 16 brain regions, such as frontal cortex, central amygdaloid nucleus, medial septum, periventricular nucleus (preoptic) and nucleus of the solitary tract. Low concentrations of MCH-LI (less than 250 fmol/mg protein) were measured in 9 brain regions such as cortical areas, hippocampus, caudate nucleus and substantia nigra. Cervical spinal cord and neurointermediate lobe of the pituitary gland contain low concentrations of the peptide.     

Dosage of lactate in the cerebrospinal fluid in infectious diseases of the central nervous system.

This paper analyzes the diagnosis aid of the dosage of lactate in the cerebrospinal fluid (CSF) in infectious diseases of the central nervous system (CNS). We analyzed prospectively 130 samples of CSF of 116 patients with diagnoses of infectious processes in the CNS. The 130 samples of CSF were divided into five groups: 28 samples of the control group, 40 of bacterial meningitis, 22 of viral meningitis, 16 of fungal meningitis and 24 of patients presenting acquired immune deficiency syndrome (AIDS). The concentration of lactate in the CSF was elevated in the group of patients with bacterial meningitis (average = 46.2 mg/dL), fungal meningitis (average = 27.3 mg/dL) and in the AIDS group (average = 23.5 mg/dL). In the control group and viral meningitis group the lactate content in the CSF presented the reference rates according to the employed method. The lactate dosage in the CSF presented a negative correlation with glycorrhachia and positive correlation with the cellularity and total proteins of the CSF. We conclude that the lactate dosage in the CSF, although unspecific, helps to distinguish the infectious processes of the CNS.     

Beta-2-microglobulin in the cerebrospinal fluid of patients with infections of the central nervous system

Beta-2-microglobulin was determined in 147 patients admitted to hospital because of suspicion of CNS disease. Patients with meningism were chosen as control group. The concentration of beta-2-microglobulin in the spinal fluid of control patients was correlated with age. Reference values for 0-40 years were 0.34-1.58 mg/l. Above 40 years of age the values were 0.46-3.14 mg/l. CSF beta-2-microglobulin levels of patients with meningism, aseptic and bacterial meningitis overlap too much to be relevant in distinguishing between these entities. Five patients with herpes simplex encephalitis had markedly elevated levels ranging from 4.4 to 9.0 mg/l. Ten patients with herpes zoster-associated encephalitis had values from 1.1 to 6.1 mg/l. In the patient groups with CNS infections, the ratio of serum to spinal fluid beta-2-microglobulin was significantly more frequently less than 1 as compared with the meningism group, indicating intrathecal production of the protein. Further studies on the clinical relevance of CSF beta-2-microglobulin in the diagnosis of encephalitis seem warranted.     

Sites of origin in the central nervous system of monoamine metabolites measured in human cerebrospinal fluid

The concentrations of homovanillic acid (HVA) and 5-hydroxyindole-acetic acid (5-HIAA) were measured in five cases with partial or complete block of CSF circulation, at various levels. Determinations were made in both a lumbar and a cisternal, or `mixed', sample obtained during pneumoencephalography. Most of the HVA appears to enter the ventricular system at the lateral ventricles, whereas much of the 5-HIAA in CSF originates in lower neuronal structures, including the spinal cord. The spinal contribution to the 5-HIAA content of lumbar CSF is of the order of 23-37%.     

Secondary lymphoid organ chemokines are elevated in the cerebrospinal fluid during central nervous system inflammation

Secondary lymphoid organ chemokines have been implicated in chronic inflammation. Their expression in the central nervous system (CNS) has not been studied. Here, levels of secondary lymphoid organ chemokines CCL19 (Exodus-3, MIP-3beta), CCL21 (Exodus-2, 6Ckine, SLC) and CXCL12 (SDF-1alpha) were analysed by ELISA in cerebrospinal fluid (CSF) and plasma from patients with multiple sclerosis (MS); acute optic neuritis (ON) with oligoclonal IgG in the CSF (i.e., first bout of MS); acute ON without oligoclonal IgG (non-MS-type ON); other inflammatory neurological diseases (OIND); and non-inflammatory neurological diseases (NIND). NIND CSF contained CCL19 and CXCL12, while CCL21 was not detected. Intrathecal production of CCL19 and CCL21 was elevated in MS, MS-type ON, and OIND, but not in non-MS-type ON. In MS, CSF levels of CCL19 weakly correlated with CSF cell counts. Intrathecal production of CXCL12 was elevated only in OIND. The role of elevated CCL19 and CCL21 in MS could be retention of mature dendritic cells (DC) in the CNS, recruitment of nai;ve T cells and activated B cells, as well as de novo formation of secondary lymphoid structures in MS plaques.     

Cellular immunoregulatory mechanisms in the central nervous system: characterization of noninflammatory and inflammatory cerebrospinal fluid lymphocytes

Dual-label flow cytometric analysis of cerebrospinal fluid (CSF) and blood lymphocytes with combinations of monoclonal antibodies such as CD4 plus CD45R or Leu8, and CD8 plus CD11b was performed in 37 patients with noninflammatory neurological diseases (NINDs) to clarify the differences in cellular immunoregulatory mechanisms present in the central nervous system (CNS) and in the systemic circulation. In the CSF of patients with NINDs, the paucity of CD4+CD45R+ and CD8+CD11b+ cells was striking, whereas the same subsets accounted for substantial proportions in the blood. CD4+CD45R- and CD4+Leu8- cells as well as CD8+CD11b- cells increased in the CSF when compared with those in the blood. Seven patients with active multiple sclerosis (MS) and 10 patients with other inflammatory diseases in the CNS (CNS-infl) were also studied. Patients with active MS were characterized by a consistent increase in percentage of CD4+CD45R- cells in the CSF, whereas an increase of CD4- CD45R+ cells in the CSF was a feature of the patients with CNS-infl, when compared with patients with NINDs. These findings indicate that the CNS is routinely surveyed by particular subsets of lymphocytes different from those in the blood, and cellular immune reaction in the CNS varies according to the types of CNS inflammatory conditions.     

Lyme borreliosis mimicking central nervous system malignancy: the diagnostic pitfall of cerebrospinal fluid cytology

We report two children with acute loss of neurological functions and signs of an increased intracranial pressure. Imaging techniques ruled out space occupying lesions, whereas CSF cytology indicated CNS involvement of a non-Hodgkin lymphoma in the form of abnormal lymphocytic pleocytosis with malignancy criteria fulfilling lymphoid cells. CSF protein electrophoresis and Borrelia burgdorferi serology revealed neuroborreliosis which was successfully treated with antibiotic therapy. The malignancy mimicking cytology is based on a blastoid transformation of B- and T-lymphocytes due to the antigenic stimulus of B. burgdorferi infection. Lymphoid cells in the CSF of a patient with acute or chronic neurological symptoms raise the differential diagnosis of inflammatory etiology versus CNS lymphoma. Monomorphism and higher quantity of the lymphoid cells point to CNS lymphoma. A lower quantity and polyclonal pattern of lymphoid cells associated with an elevated protein fraction caused by intrathecal immunoglobulin synthesis suggest an inflammatory etiology.     

Distribution of gonadrotropin releasing hormone agonist binding sites in the rat central nervous system

Specific binding sites for gonadotropin releasing hormone (GnRH) in the central nervous system of the rat were studied with in vitro autoradiography and with radioligand assays. The results show that GnRH binding sites are present in the lamina glomerulosa and plexiformis externa, the nucleus olfactorius anterior pars externa, and the frontal cortex at the sulcus rhinalis. In the septum, only a few GnRH binding sites are detected in the lateral and dorsal portions of the nucleus septi lateralis. In addition, a small number of GnRH receptors are seen in the mediobasal hypothalamus and amygdala while substantial binding is apparent in the interpeduncular nucleus, central gray and superior collicle. In the hippocampal formation the GnRH agonists bind to the dorsal and ventral subiculum as well as to receptors in the areas CA1 through CA4. The highest concentration of GnRH receptors is found in the parasubiculum. Competitive binding assays with membrane preparations from the hippocampus and interpeduncular nucleus indicate that the binding of the GnRH agonists is reversible and has a binding affinity of 1 X 10(9) M-1. Injections of radioactive GnRH agonist Buserelin into the lateral ventricle results in selective and reversible labeling of the hippocampal areas CA1 through CA4 as well as the interpeduncular nucleus, central gray and the parasubiculum. The results of the present study indicate that GnRH binds to specific receptors in select areas of the central nervous system of the rat where the peptide may regulate sensory, behavioral and endocrine events.(ABSTRACT TRUNCATED AT 250 WORDS)     

Thyrotropin-releasing hormone in lamprey central nervous system

Thyrotropin-releasing hormone (TRH) levels were measured by radioimmunoassay in the CNS of larval and adult sea lampreys and adult river lampreys. In larval sea lampreys, the pituitary complex contained approx. 609 pg TRH/mg, brain contained 43.5 +/- 5.5 pg/mg (mean +/- S.E.M.) while the spinal cord contained 11.2 +/- 2.3 pg/mg. Corresponding levels in the adult sea and river lampreys were similar. Complete spinal transection did not significantly alter TRH levels below the lesion. Thus, the spinal cord contains TRH independent of supraspinal axonal projections.