RESUMO
In multiple sclerosis intrathecal IgM synthesis correlates with an unfavourable disease course. Whether this reflects a pathogenic role of IgM, possibly in conjunction with complement, is a matter of debate. In a cross-sectional study we measured intrathecal synthesis of IgM and the complement component C3, and on cranial MRI lesion load and central brain atrophy in clinically active patients, 17 relapsing-remitting, 16 secondary progressive. Correlative analysis showed that in relapsing-remitting patients CSF IgM index correlated with cranial MRI T2 and T1 lesion load, and central brain atrophy; and the C3 index correlated with T2 lesion load. In secondary progressive patients CSF IgM index correlated with periventricular T2 lesion load. Our data are in favour of a pathogenic role of IgM in multiple sclerosis.
Assuntos
Encéfalo/patologia , Imunoglobulina M/líquido cefalorraquidiano , Esclerose Múltipla/líquido cefalorraquidiano , Esclerose Múltipla/patologia , Adulto , Atrofia , Proteínas do Sistema Complemento/líquido cefalorraquidiano , Estudos Transversais , Progressão da Doença , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Recidiva , Remissão EspontâneaRESUMO
BACKGROUND: This study was aimed to develop a sensitive and rapid assay for the determination of glial fibrillary acidic protein (GFAP) in serum and to evaluate the clinical applicability in serum samples from patients with acute stroke. METHODS: The two-site chemiluminometric immunoassay, intended to use in a near-patient setting with a single incubation step (20 min), was used to measure serum samples from healthy blood donors and from patients with brain injury and correlated to serum S100B levels. RESULTS: The GFAP assay covered a concentration range up to 18 microg/L with an analytical sensitivity of 0.014 microg/L. The intra-assay precision was 3.5% at 1.55 microg/L (n=20) and 4.1% at 0.39 microg/L (n=20). The inter-assay precision was 3.8% at 9.1 microg/L (n=10) and 10.3 % at 0.21 microg/L (n=9). Normal controls (n=46) showed non-detectable GFAP with a 99% upper limit of <0.04 microg/L. GFAP values were associated with progression and severity of the illness in acute stroke patients. CONCLUSIONS: We have developed an improved assay for the measurement of GFAP levels in serum. Serum GFAP is a potential marker for prognosis and outcome in patients with central nervous system disorders.
Assuntos
Lesões Encefálicas/sangue , Proteína Glial Fibrilar Ácida/sangue , Imunoensaio/métodos , Doença Aguda , Idoso , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Humanos , Medições Luminescentes/métodos , Masculino , Pessoa de Meia-Idade , Fatores de Crescimento Neural/sangue , Reprodutibilidade dos Testes , Subunidade beta da Proteína Ligante de Cálcio S100 , Proteínas S100/sangue , Acidente Vascular Cerebral/sangue , Fatores de TempoRESUMO
BACKGROUND: In the present study, a new assay for the measurement of glial fibrillary acidic protein (GFAP) in human blood is described. The aim of the study was to present the characteristics of a new GFAP assay for blood analysis. METHODS: The method, a newly developed enzyme-linked immunosorbent assay (ELISA), was validated using blood samples from healthy blood donors and from patients with severe traumatic brain injury (TBI). RESULTS: 22 out of 72 healthy blood donors had a detectable GFAP level. The reference values (percentiles) are as follows: P50=0.15 microg/l and P95=0.49 microg/l; range 0.15-0.76 microg/l. CONCLUSIONS: GFAP in blood might be a promising new marker for astrocyte involvement after acute brain damage.
