Relationships of Cerebrospinal Fluid Alzheimer's Disease Biomarkers and COMT, DBH, and MAOB Single Nucleotide Polymorphisms.

The noradrenergic and dopaminergic systems are affected in Alzheimer's disease (AD). Polymorphisms in genes encoding enzymes and proteins that are components of these systems can affect products of transcription and translation and lead to altered enzymatic activity and alterations in overall dopamine and noradrenaline levels. Catechol-O-methyltransferase (COMT) and monoamine oxidase B (MAOB) are the enzymes that regulate degradation of dopamine, while dopamine ß-hydroxylase (DBH) is involved in synthesis of noradrenaline. COMT Val158Met (rs4680), DBH rs1611115 (also called -1021C/T or -970C/T), and MAOB rs1799836 (also called A644G) polymorphisms have been previously associated with AD. We assessed whether these polymorphisms are associated with cerebrospinal fluid (CSF) AD biomarkers including total tau (t-tau), phosphorylated tau proteins (p-tau181, p-tau199, and p-tau231), amyloid-ß42 (Aß42), and visinin-like protein 1 (VILIP-1) to test possible relationships of specific genotypes and pathological levels of CSF AD biomarkers. The study included 233 subjects: 115 AD, 53 mild cognitive impairment, 54 subjects with other primary causes of dementia, and 11 healthy controls. Significant decrease in Aß42 levels was found in patients with GG compared to AG COMT Val158Met genotype, while t-tau and p-tau181 levels were increased in patients with AA compared to AG COMT Val158Met genotype. Aß42 levels were also decreased in carriers of A allele in MAO-B rs1799836 polymorphism, while p-tau181 levels were increased in carriers of T allele in DBH rs1611115 polymorphism. These results indicate that COMT Val158Met, DBH rs1611115, and MAOB rs1799836 polymorphisms deserve further investigation as genetic markers of AD.

Schizophrenia: dopamine beta-hydroxylase activity and treatment response.

Cerebrospinal fluid levels of dopamine beta-hydroxylase, found to be relatively constant over time in individual patients, were significantly lower in schizophrenic patients who became nonpsychotic during neuroleptic treatment than in those who remained psychotic. Dopamine beta-hydroxylase activity may delineate a subgroup of patients who have a dopamine-sensitive brain disorder.

Dopamine-beta-hydroxylase activity and homovanillic acid in spinal fluid of schizophrenics with brain atrophy.

Schizophrenic patients with high ventricle brain ratios and cortical brain atrophy, as shown by computerized tomography, had decreased spinal fluid concentrations of homovanillic acid and dopamine-beta-hydroxylase activity. These decreased cerebral spinal fluid concentrations in patients with brain atrophy support the proposal of disturbed noradrenaline and dopamine neurotransmission in a subgroup of schizophrenic patients.

Polymorphisms and low plasma activity of dopamine-beta-hydroxylase in ADHD children.

Attention-deficit Hyperactivity disorder (ADHD) is a multifactorial disorder clinically characterized by inattentiveness, impulsivity and hyperactivity. The occurrence of this disorder is between 3 and 6% of the children population, with boys predominating over girls at a ratio of 3:1 or more. The research of some candidate genes (DRD4, DAT, DRD5, DBH, 5HTT, HTR1B and SNAP25) brought consistent results confirming the heredity of ADHD syndromes. Dopamine-beta-hydroxylase (DBH) is an enzyme responsible for the conversion of dopamine into noradrenaline. Alteration of the dopamine/noradrenaline levels can result in hyperactivity. The DBH protein is released in response to stimulation. DBH activity, derived largely from sympathetic nerves, can be measured in human plasma. Patients with ADHD showed decreased activities of DBH in serum and urine. Low DBH levels correlate indirectly with the seriousness of the hyperkinetic syndrome in children [19,20]. In the DBH gene, the G444A, G910T, C1603T, C1912T, C-1021T, 5 -ins/del and TaqI polymorphisms occur frequently and may affect the function of gene products or modify gene expression and thus influence the progression of ADHD. This article reviews the DBH itself and polymorphisms in the DBH gene that influence the DBH activity in the serum and the CSF level of DBH. All those are evaluated in connection with ADHD.

Dopamine beta-hydroxylase in CSF. Relationship to personality measures.

Dopamine beta-hydroxylase (DBH), the enzyme that converts dopamine to norepinephrine, was measured in the CSF of 32 subjects. Those individuals with a low level of DBH in the CSF had significantly elevated profiles on the Minnesota Multiphasic Personality Inventory, suggesting a relationship between the central noradrenergic system and some aspects of personality in man.

CSF dopamine beta-hydroxylase in schizophrenia.

Dopamine beta-hydroxylase (DBH), the enzyme that converts dopamine to norepinephrine, was measured in the CSF of 30 schizophrenic patients and 27 normal controls. The CSF DBH activity in the patients was not significantly different from that in controls. Levels of CSF DBH activity in individual patients were highly constant over time and were not influenced by clinical state or neuroleptic treatment. Low levels of DBH in CSF did significantly relate to good social and sexual functioning, good prognosis, less symptoms between hospitalizations, and excellent clinical response to neuroleptic treatment. We speculate from these data that low brain DBH activity may produce a type of vulnerability to psychotic decompensation and thereby influence the clinical course, although it does not cause schizophrenia, in general. Low CSF DBH activity may delineate a "reactive" subgroup from the heterogenous population of patients with diagnoses of schizophrenia.

Raised cerebrospinal fluid norepinephrine in some patients with primary hypertension.

To test whether central neurogenic factors participate in blood pressure elevation in primary hypertension, we studied the concentrations of: norepinephrine, epinephrine and dopamine-beta-hydroxylase (DBH) in cerebrospinal fluid (CSF); and norepinephrine, epinephrine, DBH and plasma renin activity (PRA) in plasma of 22 subjects (seven with primary hypertension, 11 normotensive patients with non-systemic neurological disorders, and four with secondary hypertension). Plasma and CSF norepinephrine (NE) were increased in primary hypertensives compared to normotensives. Cerebrospinal fluid norepinephrine was related to diastolic blood pressure, and systolic blood pressure when normotensive and primary hypertensives were taken together. The CSF norepinephrine of primary hypertensive patients was correlated with natural log PRA. The CSF norepinephrine was correlated inversely with age in primary hypertensive patients but not in the normotensive subjects. The low CSF norepinephrine and epinephrine, despite markedly increased plasma NE and epinephrine, in two patients with pheochromocytoma, indicate a blood-brain barrier for these neurohormones. The observations support the view that the central sympathetic nervous system is involved in the pathogenesis of primary hypertension, particularly in younger patients.

Cerebrospinal fluid and plasma dopamine-beta-hydroxylase activity in human hypertension.

Cerebrospinal fluid (CSF) and plasma dopamine-beta-hydroxylase (DBH) activity was measured in 22 normotensive (NT), 31 essential hypertensive (EH), and 11 renal hypertensive (RH) patients. Although no differences were observed in their plasma DBH, the mean CSF-DBH activity and specific activity of EH were significantly lower than those of NT and RH patients. Very low CSF-DBH (less than 0.15 units/ml of CFS or less than 0.5 units/mg of CSF protein) was found only in EH (26% of EH). Of the 31 EH patients, 19(60%) had CSF-DHB activities lower than 0.5 units/ml, whereas only 5 of 22 NT (23%) and no RH fell within this range. Nevertheless, 20% of EH, 55% of NT, and 40% of RH patients had CSF-DBH activities above the mean value for NT (less than 0.9 units/ml). NT subjects with very low plasma DBH (less than 50 units/ml) had CSF-DBH activities that fell within normal range. With the exception of these subjects, the specific activity of CSF-DBH was always lower than that of the plasma enzyme. The concentration of albumin, alpha 1, beta, and gamma globulins was measured in plasma and CSF obtained from the last five NT, four EH, and two RH patients. A positive linear relationship was obtained when the log of the plasma/CSF concentration ratio for these proteins was plotted against their molecular weight. Similar slopes and intercepts were obtained for these patients, suggesting that no major differences seem to exist in their blood-brain-barrier permeability to proteins. The results suggest that measurements of CSF-DBH could be of help in the differential diagnosis of human hypertension and in the neurochemical characterization of EH. If CSF-DBH reflects central noradrenergic activity, its reduction might indicate the existence of a central catecholaminergic defect in a subgroup of EH patients.

Serum dopamine-beta-hydroxylase activity and lateral ventricular size in affective disorders and schizophrenia.

Previous studies have reported a significant negative correlation between cerebrospinal fluid DBH activity and ventricular brain ratio (VBR) in schizophrenic patients. We now report a significant negative correlation between log serum DBH activity and VBR in 28 patients with major depression (r = -0.41, p = 0.04); this correlation was also negative (r = -0.15), but not significant, in 46 schizophrenics. Eight patients (five schizophrenic, three affective disorder) with increased VBR had significantly lower serum DBH activity than the patients with normal VBR. The relationship between low CSF or serum DBH activity and increased VBR may be manifestations of the polygenetic vulnerability common to the major psychoses.

Dopamine-beta-hydroxylase in the cerebrospinal fluid of psychiatric patients.

The activity of dopamine-beta-hydroxylase (DBH) in cerebrospinal fluid (CSF) from 59 psychiatric patients has been analyzed by a highly sensitive radio-enzymatic assay. There was no sex difference in DBH, but there was a significant positive correlation with age. Probenecid administration had no effect on CSF DBH. DBH in CSF correlated positively (r = 0.60) with the plasma enzyme. Among patients hospitalized for major depressive disorder, unipolar or bipolar, schizo-affective disorder, schizophrenia, alcoholism, or personality disorders there were no significant between-group differences. Among the patients with bipolar affective disorder, DBH activity from manic patients was significantly lower than that from depressed or euthymic patients. The results are discussed with reference to the theory that the amount of DBH in CSF may serve as an indicator of central noradrenergic activity.

Dopamine-beta-hydroxylase in the cerebrospinal fluid: relationship to disulfiram-induced psychosis.

Cerebrospinal fluid (CSF) dopamine-beta-hydroxylase (DBH) activity in 32 male alcoholics was measured using a modification of the radioenzymatic method of Molinoff et al. In most, the CSF was obtained before treatment with disulfiram, while in others it was obtained while they were on the drug (250 or 500 mg). As expected, treatment with this reversible DBH inhibitor had no effect on the activity of the enzyme measured in our in vitro assay. However, low pretreatment DBH activity was found to correlate with adverse reactions to disulfiram. Mean DBH activity of four individuals who went on to become psychotic on disulfiram was 0.13 +/- 0.02 nmole/ml per hr (mean +/- SEM). An additional four individuals who developed dysphoric but nonpsychotic reactions had a mean DBH of 0.23 +/- 0.03. Both these values were significantly lower than the mean DBH activity of the remaining 24 individuals treated with disulfiram who had no adverse side effects, 0.53 +/- 0.06 p less than 0.02 and p less than 0.05, respectively, 2-tailed t-test.

CSF dopamine beta-hydroxylase in schizophrenia: associations with premorbid functioning and brain computerized tomography scan measures.

OBJECTIVE: The authors attempted to replicate previous findings of relationships of CSF dopamine beta-hydroxylase with premorbid functioning and computerized tomography (CT) scan measures in a new cohort of schizophrenic patients. METHOD: Data on CSF dopamine beta-hydroxylase-like immunoreactivity and premorbid functioning, as well as CT scans, were obtained in 60 drug-free, male schizophrenic patients and two groups of normal comparison subjects. RESULTS: CSF dopamine beta-hydroxylase did not differ between the comparison subjects and schizophrenic patients. Lower CSF dopamine beta-hydroxylase was associated with better premorbid social functioning and with less prefrontal sulcal widening. Better premorbid school functioning and more years of education, however, were associated with higher CSF dopamine beta-hydroxylase. CONCLUSIONS: The association between low CSF dopamine beta-hydroxylase and premorbid functioning was confirmed for social functioning, while the opposite was observed for scholastic performance, suggesting that these are different dimensions. Dopamine beta-hydroxylase modulates the prognosis and potentially the course of schizophrenia without necessarily causing the disorder.

CSF dopamine-beta-hydroxylase activity in Parkinson's disease.

Although the most prominent neurochemical change in parkinsonism is nigrostriatal dopamine deficiency, norepinephrine content is also diminished in the CNS. In this study, dopamine-beta-hydroxylase (DBH) activity, a marker of central noradrenergic activity, was measured in the CSF of previously unmedicated parkinsonian patients and normal controls. The parkinsonian patients showed a reduction in CSF DBH levels to 41% of control values (p less than 0.01). Possible explanations for the decrease included a decreased noradrenergic nerve pool or a diminished rate of synthesis of catecholamines.

Dopamine beta-hydroxylase activity in cerebrospinal fluid of idiopathic torsion dystonia.

Since a postmortem biochemical study and a genetic linkage study of idiopathic torsion dystonia suggested possible involvement of dopamine beta-hydroxylase (DBH), we determined CSF DBH activities of Jewish and non-Jewish patients with childhood-onset idiopathic torsion dystonia and found no differences from a control population.

Dopamine-beta-hydroxylase deficiency in humans.

We report a 42-year-old man with dopamine-beta-hydroxylase deficiency, an autonomic disorder characterized by lifelong severe orthostatic hypotension, ptosis, nasal stuffiness, hyperextensible joints, and retrograde ejaculation. There is isolated deficiency of norepinephrine in both central and peripheral neurons, which contain and release dopamine instead. Dopamine-beta-hydroxylase deficiency should be suspected also in infants presenting with delayed eye opening, hypoglycemia, hypothermia, or hypotension. It can be diagnosed definitively by assay of plasma norepinephrine and dopamine.

The presence of dopamine beta-hydroxylase in the cerebrospinal fluid of rabbits and its increased concentration after stimulation of peripheral nerves and cold stress.

The presence of dopamine beta-hydroxylase activity in the cerebrospinal fluid of rabbits has been shown using a sensitive radiochemical assay; the identity of the reaction product was confirmed by using thin layer chromatographic techniques. The enzyme found in this fluid has some properties (sedimentation and electrophoretic migration) in common with the best characterized preparation of dopamine beta-hydroxylase, that prepared from bovine adrenal chromaffin granules. It also has these properties in common with the enzyme present in the high-speed supernatants obtained from osmotically disrupted synaptosomes prepared from rabbit brain. When the sciatic nerves of rabbits under urethane anaesthesia were stimulated, or when shaved rabbits were subjected to cold stress, the level of dopamine beta-hydroxylase in the cerebrospinal fluid increased. The increase in response to nerve stimulation was gradual, starting within 90 min of stimulation and remained high for at least 3 h after the stimulation had ended, at which time it was 280% of the normal value. There was no equivalent increase in the protein concentration of the cerebrospinal fluid nor was there a change in the enzyme activity when sciatic nerves were exposed but not stimulated. The enzyme present in the cerebrospinal fluid during this period of high activity is identical in its sedimentation and electrophoretic properties to that present in normal fluid. It is suggested that the dopamine beta-hydroxylase activity in cerebrospinal fluid may be derived from noradrenergic neurons within the brain and that the enzyme is released together with noradrenaline.

Evaluation of parameters for central neuronal activity in cerebrospinal fluid of rabbits following yohimbine.

Rabbits were treated intravenously with yohimbine at a dose of 5 mg/kg. The concomitant increase in noradrenergic activity was followed in function of time by measuring dopamine-beta-hydroxylase activity and 3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) and 3-methoxy-4-hydroxymandelic acid (VMA) levels in cerebrospinal fluid. In addition, the effect of yohimbine on the dopaminergic, serotonergic and enkephalinergic neurotransmission was also determined. For this purpose, the dopamine metabolite, 3-methoxy-4-hydroxyphenylacetic acid (HVA), the serotonin metabolite, 5-hydroxy-indole acetic acid (5-HIAA) and methionine-enkephalin (Met-Enk) were quantified. The D beta H activity in control experiments, in which physiological saline was administered, increased up to 200% whereas in the yohimbine experiments a rise to 500-600% was observed. VMA and MHPG levels increased to 290%, and 209% respectively. HVA levels reached a value of 233% versus the concentration before drug injection, whereas 5-HIAA concentrations initially slightly increased and thereafter decreased. In the corresponding control experiments metabolite concentrations were virtually stable. Following yohimbine injection, methionine-enkephalin concentrations did not show significant variations compared with the control experiments. We conclude that noradrenergic and dopaminergic neurotransmission are increased following administration of the alpha 2-antagonist yohimbine whereas serotonergic neurotransmission is slightly decreased and enkephalinergic neurotransmission is unaltered. The value of the different parameters for measuring neuronal activity in cerebrospinal fluid is discussed.

Concentrations of monoamine metabolites in the cerebrospinal fluid of twins and unrelated individuals--a genetic study.

The concentrations of the major monoamine metabolites, homovanillic acid (HVA), 3-methoxy-4-hydroxyphenylethylene glycol (MOPEG), and 5-hydroxyindoleacetic acid (5-HIAA) in the cerebrospinal fluid (CSF), of platelet monoamine oxidase (MAO) and of dopamine beta-hydroxylase (DBH)-activity in serum and CSF were determined in pairs of healthy mono- and dizygotic twins, brothers and unrelated individuals. Intraclass correlations were calculated for each category of pairs. Of the monoamine metabolites, only MOPEG was found to be under any major genetic influence. Genetic heritability for MOPEG was 0.74 with no evidence of cultural heritability or environment common to twins. For HVA and 5-HIAA, a familial influence was found, where the cultural heritability was higher than the genetic. As in previous studies of MAO in blood platelets and of DBH activity in serum, there was strong evidence for a genetic component. The genetic heritability for MAO was 0.78. For DBH in serum the genetic component was 0.98, and for DBH in CSF, 0.83. The demonstration of a familial influence on 5-HIAA and HVA in CSF requires a more detailed analysis of the character of such environmental and genetic influences, using more direct techniques.

Dopamine-beta-hydroxylase in cerebrospinal fluid and plasma: effects of alpha-adrenergic agents.

Dopamine-beta-hydroxylase (DBH) and norepinephrine are both localized in noradrenergic storage vesicles. When noradrenergic nerves fire, both norepinephrine and DBH are released by exocytosis. DBH released from the peripheral nervous system and the adrenal medullae is found in blood, while DBH in cerebrospinal fluid (CSF) is presumably of central origin. This study was designed to: (1) investigate the effect of drugs which alter central noradrenergic activity on DBH activity in CSF; and (2) compare the effects of these drugs on DBH in CSF and plasma in cats. Phenoxybenzamine was given subcutaneously at 6 mg/kg and DBH was measured 8 h later. This treatment significantly increased DBH activity in CSF (n = 10,P less than 0.005). There were no consistent changes in plasma DBH, although there was a tendency for DBH to increase from low basal levels and to decrease from high basal levels. Clonidine was administered in 4 subcutaneous injections (100, 50, 50, 50 microgram/kg) over a 19-h period, and blood and CSF were taken 5 h after the last injection. This treatment caused a significant decrease in CSF DBH activity (P less than 0.05, n = 8). The effect of clonidine on plasma DBH was strongly dependent on the basal enzyme level. The 3 lowest DBH values increased and the 5 highest DBH values decreased on drug treatment. These results are discussed with respect to the theory that changes in CSF DBH may reflect central noradrenergic activity.

Central noradrenergic adaptation to long-term treatment with imipramine in rhesus monkeys.

Rhesus monkeys were treated with the antidepressant drug imipramine; cerebrospinal fluid norepinephrine and dopamine-beta-hydroxylase were measured to assess central noradrenergic activity. Large changes occurred after short-term, but not long-term, treatment. Biochemical stabilization occurs at the time when therapeutic effects are seen in patients.