神经系统疾病患者脑脊液及血清前列腺素D合酶的变化

Dimitrios N Melegos , Mark S Freedman , Eleftherios P Diamandis
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引用次数: 50

摘要

前列腺素D合成酶(PGD合成酶)或β微量蛋白是人脑脊液(CSF)的主要成分,约占脑脊液总蛋白的3%。我们最近开发了一种高度特异性的PGD合成酶免疫荧光测定法,使我们能够量化与中枢神经系统无关的液体和组织中PGD合成酶的存在。在本报告中,我们提供了302例患有各种神经系统疾病和症状的受试者CSF和血清中PGD合酶存在的定量数据。脑脊液中PGD合酶水平约为血清的35倍,中位浓度为11299 μg/L。脑脊液中PGD合酶浓度与患者年龄和性别均有统计学意义。血清PGD合酶浓度与患者年龄、性别无相关性。为评价PGD合酶在诊断神经系统疾病中的临床应用价值,对268例已确诊的神经系统疾病患者的脑脊液和血清中PGD合酶的分布规律进行了检测。多发性硬化症患者脑脊液(129例)或血清(94例)PGD合酶浓度与所有其他研究患者相比无统计学差异。HIV/AIDS相关神经病、病毒性脑膜炎和纤维肌痛患者脑脊液中PGD合酶水平的分布模式也无差异。我们得出结论,PGD合酶测量在诊断成人神经系统疾病方面没有临床应用。PGD合酶可能在脑发育和神经退行性疾病中具有生理和/或病理作用。
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Prostaglandin D Synthase Concentration in Cerebrospinal Fluid and Serum of Patients with Neurological Disorders

Prostaglandin D synthase (PGD synthase) or β-trace protein is a major constituent of human cerebrospinal fluid (CSF) representing ∼3% of the total CSF protein. We have recently developed a highly specific immunofluorometric assay for PGD synthase, which enabled us to quantify the presence of PGD synthase in fluids and tissues not associated with the CNS. In this report we provide quantitative data of the presence of PGD synthase in CSF and serum from 302 subjects with various neurological diseases and symptoms. PGD synthase levels in CSF are approximately 35-fold higher than those of serum, with a median concentration of 11299 μg/L. A statistically significant association of PGD synthase concentration in CSF was observed with both patient age and gender. There was no correlation between PGD synthase concentration in serum and patient age or gender. To evaluate the clinical utility of PGD synthase in diagnosing neurological diseases, the distribution pattern of PGD synthase in CSF and serum was examined for each neuropathology of 268 patients whose diagnosis was known. No statistical difference was observed between PGD synthase concentration in the CSF (129 cases) or the serum (94 cases) of multiple sclerosis afflicted subjects in comparison to all other patients studied. The distribution pattern was also not different for PGD synthase levels in CSF of patients with HIV/AIDS related neuropathies, viral meningitis and fibromyalgia. We conclude that PGD synthase measurement presents no clinical utility in diagnosing neurological disorders in adulthood. PGD synthase may have a physiological and/or pathological role in the developing brain and in neurodegenerative diseases.

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