CSF proteome: a protein repository for potential biomarker identification.

Proteomic analysis is not limited to the analysis of serum or tissues. Synovial, peritoneal, pericardial and cerebrospinal fluid represent unique proteomes for disease diagnosis and prognosis. In particular, cerebrospinal fluid serves as a rich source of putative biomarkers that are not solely limited to neurologic disorders. Peptides, proteolytic fragments and antibodies are capable of crossing the blood-brain barrier, thus providing a repository of pathologic information. Proteomic technologies such as immunoblotting, isoelectric focusing, 2D gel electrophoresis and mass spectrometry have proven useful for deciphering this unique proteome. Cerebrospinal fluid proteins are generally less abundant than their corresponding serum counterparts, necessitating the development and use of sensitive analytical techniques. This review highlights some of the promising areas of cerebrospinal fluid proteomic research and their clinical applications.

Elevated glutamic acid values in a malnourished patient. A case report.

Routine serum and cerebrospinal (CSF) amino acid estimations were carried out on a patient with pellagra and malnutrition. Urea levels were low and serum and CSF ammonia levels elevated. A remarkable observation was that the serum glutamic acid level rose to 44.9 times normal, which is far higher than any value reported in the medical literature. At this stage no explanation for this rise is known. Similarly no explanation can be given for the posttreatment elevation of the CSF proline levels to 13.8 times above normal.