Cerebrospinal fluid substance P concentrations are elevated in patients with Alzheimer's disease.

The neuropeptides substance P, orexin A (hypocretin-1) and neurotensin are signaling molecules that influence brain activity. We examined their cerebrospinal fluid (CSF) levels in a study population consisting of Alzheimer's disease (AD) dementia or mild cognitive impairment (MCI) diagnosed with AD dementia upon follow-up (n=32), stable MCI (SMCI, n=13), other dementias (n=15), and healthy controls (n=20). CSF substance P level was increased in AD patients compared to patients with other dementias and healthy controls (P<0.05 and P<0.01, respectively). Patients with other dementia or SMCI had lower CSF orexin A level than AD patients (both P<0.05) and marginally lower level than healthy controls (both P=0.05). CSF neurotensin level was similar in all groups. In the total study population (n=80), CSF substance P level correlated positively with CSF levels of T-tau and P-tau, and in AD patients (n=32), CSF substance P level correlated positively with CSF Aß1-42 level. In conclusion, CSF substance P level was elevated in AD patients and correlated with CSF Aß1-42 level, a well established marker of senile plaque pathology. The role of low CSF orexin A level in other dementias or SMCI needs to be explored in further studies.

Cerebrospinal fluid xenin levels during body mass reduction: no evidence for obesity-associated defective transport across the blood-brain barrier.

CONTEXT: Recent studies have shown that xenin can act in the hypothalamus, reducing food intake through a leptin- and melanocortin system-independent mechanism. OBJECTIVE: To evaluate the impact of body mass reduction on the blood and cerebrospinal fluid (CSF) levels of xenin. DESIGN AND SETTING: Thirteen obese patients (11 women) selected for roux-in-Y gastric bypass surgery were evaluated before and approximately 8 months after surgery. Xenin was determined in serum and CSF by radioimmunoassay. RESULTS: As compared with lean subjects, obese patients have increased blood levels of xenin, which reduce after surgery. There are significant correlations between blood xenin and blood leptin and insulin levels. CSF concentration of xenin is ∼10-fold lower than blood levels, and is significantly higher in obese subjects as compared with lean ones, returning to normal levels after body mass reduction. There is a significant linear correlation between CSF and blood levels of xenin. CONCLUSION: Xenin is present in the human CSF in a concentration ∼10-fold lower than the blood. Both blood and CSF xenin are correlated with blood levels of important markers of adiposity, leptin and insulin. The levels of CSF xenin are linearly correlated with blood xenin, independently of patient body mass, suggesting that either its transport across the blood-brain barrier is not saturated in the concentration range detected in this study or that there is a coordinated release of xenin from the periphery and the CNS.

Solid-phase extraction-field-amplified sample injection coupled with CE-ESI-MS for online pre-concentration and quantitative analysis of brain-gut peptides.

In order to improve the sensitivity of CE-ESI-MS for the analysis of brain-gut peptides, a solid-phase extraction combined with field-amplified sample injection was used for the pre-concentration of the brain-gut peptides. Compared with the conventional pressure injection method, the sensitivity in the detection of brain-gut peptides was improved more than 100-fold. The possible factors affecting sample stacking, such as the sample matrix, the composition and the length of the water column, the types and the volumes of eluent, have been investigated in detail. Under the optimum conditions, the detectable concentration of brain-gut peptides was found to be as low as 0.02 µM. A linear response concentration for the detection was developed in the range of 0.08-25 µmol/L. A real sample of human cerebrospinal fluids, which was spiked with brain-gut peptides, was also examined in order to evaluate the reliability of the proposed approach. The recovery of the method was in a range from 69.2 to 85.4%. The method was found to be reliable, accurate and potentially applicable for clinical drug analysis.

Separation and determination of peptide hormones by capillary electrophoresis with laser-induced fluorescence coupled with transient pseudo-isotachophoresis preconcentration.

A new method for the determination of the peptide hormones and their fragments by capillary electrophoresis (CE) with laser-induced fluorescence (LIF) detection and transient pseudo-isotachophoresis (pseudo-tITP) preconcentration was established in this study. The LIF detector used an argon ion laser with excitation wavelength at 488 nm and emission wavelength at 535 nm. Fluorescein isothiocyanate (FITC) was used as precolumn derivatization reagent to label cholecystokinin tetrapeptide (CCK-4), neurotensin (NT), neurotensin hexapeptide (NT(8-13)), and neurokinin B (NKB). Borate (10 mmol/L, pH 9.0) was selected as derivatization medium to get the high efficiency. When the addition of 70% (v/v) methanol and 1% (m/v) sodium chloride (NaCl) to the sample matrix, and with borate buffer (110 mM, pH 9.5) and 20% (v/v) methanol as running buffer, a preconcentration based on the pseudo-tITP afforded 100-fold improvement in peak heights compared with the traditional hydrodynamic injection (2.3% capillary volume). The detection limits (signal/noise=3) based on peak height were found to be 0.04, 0.1, 0.2, and 0.08 nmol/L for NT(8-13), NT, NKB, and CCK-4, respectively. The method was validated and applied to qualitative analysis of NT and NT(8-13) in human cerebrospinal fluid sample.

Comparative sequencing of the proneurotensin gene and association studies in schizophrenia.

Neurotensin (NT) is an endogenous tridecapetide1 cleaved from a precursor proneurotensin/ proneuromedin protein. NT localises within dopaminergic neurones in the mesocortical, mesolimbic and nigrostriatal systems1-3 and it is now clear that NT can selectively modulate dopaminergic neurotransmission.2-9 These anatomical and functional connections have led to the hypothesis that NT dysfunction might contribute to the pathogenesis of neuropsychiatric disorders in which disordered dopaminergic neurotransmission is suspected, particularly schizophrenia.3 The latter hypothesis has been supported circumstantially by the observation that central administration of NT produces effects similar to those produced by the peripheral administration of atypical antipsychotics,10,11 and more directly by studies showing levels of NT in cerebral spinal fluid (CSF) is lower in schizophrenics than in controls.12,13 To allow such hypotheses to be tested, we used denaturing high performance liquid chromatography (DHPLC)14 to identify three sequence variants in the neurotensin gene (NTS) that might alter NT structure or expression. However, using a case-control study design and a novel genotyping system based upon a primer extension protocol and HPLC detection,15 we found no evidence to support the hypothesis that variation in the proneurotensin gene contributes to susceptibility to schizophrenia.

CSF neurotensin concentrations and antipsychotic treatment in schizophrenia and schizoaffective disorder.

OBJECTIVE: The relationship between CSF neurotensin concentrations and measures of psychopathology in patients with schizophrenia or schizoaffective disorder was examined before and after treatment with antipsychotic drugs. METHOD: CSF neurotensin concentrations were measured in 42 drug-free patients with schizophrenia or schizoaffective disorder. For 18 of these patients, CSF neurotensin was measure again after 4 weeks of antipsychotic treatment. RESULTS: Significantly higher levels of pretreatment psychopathology were observed in the patients with the lowest CSF neurotensin concentrations. Furthermore, improvements in overall psychopathology and, particularly, negative symptoms were correlated with increases in CSF neurotensin concentrations during treatment. CONCLUSIONS: These findings provide further evidence for a role of neurotensin the pathophysiology of psychosis and in the mechanism of action of antipsychotic drugs.

[Endorphins and neurotensin in Huntington chorea]. / Endorfiny i neirotenzin pri khoree Gentingtona.

Concentration of alpha-endorphin, beta-endorphin, gamma-endorphin and neurotensin in blood and beta-endorphin in cerebrospinal fluid of 48 patients with various forms of Huntington's disease was measured. Two modifications of immunoassay were used. The level of all neuropeptides studied was significantly decreased. Patients with a kinetiko-rigid form of the disease showed a two-fold lowering in beta-endorphin levels in cerebrospinal fluid in comparison with patients with the classic form. The relationships between these findings and clinical-biochemical characteristics of Huntington's disease are discussed.

The simultaneous determination of neurotensin and its major fragments by on-line trace enrichment HPLC with electrochemical detection.

An HPLC assay using on-line cation exchange trace enrichment and acetonitrile gradient elution, ion pair reverse phase separation with electrochemical detection (EC) is described for the simultaneous determination of the tridecapeptide neurotensin (NT) and six of its fragments. Cyclic voltammetric analysis indicated that the oxidative electrochemical properties of NT and its fragments is not merely a function of the sum of its electroactive amino acids (i.e. tyrosine) but reflects the presence and association of other amino acids (e.g. the arginine-arginine pair at position 8-9). Using the described method, NT1-6, NT1-8, NT1-10, NT1-11, NT8-13, NT9-13 and NT1-13 were baseline resolved within 20 min with a limit of detection varying from 1 to 5 ng peptide/injection. Other structurally similar or quantitatively significant neuropeptides (e.g. substance P, somatostatin, bombesin) did not interfere. Initial application of this on-line trace enrichment HPLC-EC assay to the question of the molecular nature of NT in unprocessed human CSF indicated the predominance of NT1-13 with an apparent formation of NT1-8 and NT9-13 resulting from more vigorous sample preparation techniques. The improvements in assay specificity, signal-to-noise ratios, biomatrix compatibility and assayable sample volume compared to non-enrichment HPLC-EC are discussed.

CSF concentrations of neurotensin in schizophrenia: an investigation of clinical and biochemical correlates.

Neurotensin (NT), a peptide which colocalizes with dopamine in some midbrain and hypothalamic neurons, has been speculated to play a role in schizophrenic illness and in the action of antipsychotic drugs. Previous work suggested a bimodal distribution of NT in patients with schizophrenia, with a subgroup having low drug-free NT concentrations which normalize with neuroleptic treatment. We studied 15 schizophrenic patients with CSF samples collected both off and on neuroleptic medication, 12 with only drug-free (DF) samples, and 10 controls. There was no significant difference in CSF NT concentrations between patients and controls, or between patients off and on medication. However, 7 patients with DFNT CSF concentrations below the patient mean showed an increase with neuroleptic treatment. Moreover, NT was significantly lower for women. Significant correlations with NT concentrations in CSF were found with deficit symptoms in patients, and with the age of the CSF sample for all subjects. There was no correlation between CSF NT concentrations and patient age, duration of illness, or levels of amine metabolites (MHPG, 5HIAA, HVA).

Characterization of neurotensin-like immunoreactivity in human cerebrospinal fluid by high-performance liquid chromatography combined with mass spectrometry.

This report describes the recovery and characterization of neurotensin-like immunoreactivity (NT-LI) in human cerebrospinal fluid (hCSF). A large quantity of the fluid was fractionated by gel filtration, and subsequently separated and analysed by different high-performance liquid chromatography (HPLC) systems. The recovered material was analysed by microLC continuous-flow fast atom bombardment mass spectrometry, where a close similarity between one active CSF component and native neurotensin was confirmed. It was also found that, although a certain amount of the total NT-LI behaved as authentic neurotensin, the major part of the immunoreactive material was likely to be due to prestages and metabolites of the active peptide. The present finding is of importance for the development of efficient procedures for the quantitative analysis of neurotensin in hCSF samples.

Neurochemical alterations in Rett syndrome.

The Rett syndrome (RS) is a neurological disorder associated with severe mental deficiency and neurological manifestations of cortical and extrapyramidal dysfunction. The present report is (1) a postmortem brain study that compares the levels of choline acetyltransferase (ChAT) activity and the binding density of selected neurotransmitter receptors in four cases of RS and five normal controls of similar age and (2) a study of cerebrospinal fluid (CSF) concentrations of the endogenous tridecapeptide neurotensin in 12 RS patients and 8 controls of similar age. The level of ChAT activity was lower in many cortical and subcortical regions in the RS brains as compared to control levels. The number of NMDA, AMPA, mu opioid and neurotensin binding sites, as well as CSF concentrations of neurotensin, did not differ significantly from control levels. The results suggest that changes in specific neurotransmitter systems, particularly cholinergic neurons, in the thalamus, cerebellum and basal ganglia may underlie the progressive deterioration in motor and cognitive function characteristic of this disorder.

Beta-endorphin and neurotensin in brainstem and cerebrospinal fluid in the sudden infant death syndrome.

Beta-endorphin (BE) and neurotensin (NT) are two neuropeptides which induce apneas. In infants who died of Sudden Infant Death Syndrome (SIDS) we measured, in brainstem and CSF, BE and NT by IRMA and RIA respectively. BE and NT levels are compared to same aged infant and adult controls. CSF BE level was significantly higher in SIDS than in the two control groups (86 +/- 14 vs 33 +/- 13 and 16 +/- 5 pmol/l). In 6 SIDS victims NT and BE were assayed in 5 brainstem sections, each of them divided in median, intermediate and lateral parts. We found high levels of BE in every fragment (3-11 pmol/mg protein) while NT elevated values were restricted to the mesencephalic regions (1.4-12 pmol/mg), the medial pons (6 pmol/mg) and the intermediate parts of the medulla (including the olive: 1.3-1.6 pmol/mg). These results support the hypothesis that NT and/or BE could induce or participate to the fetal issue of SIDS.

Relation of CSF neurotensin concentrations to symptoms and drug response of psychotic patients.

OBJECTIVE: The authors investigated the putative endogenous antipsychotic neurotensin in relation to both psychotic symptoms and patterns of response during treatment with an antipsychotic drug. METHOD: Twenty recently admitted patients with mood-incongruent psychoses underwent 1) interviews with the Schedule for Affective Disorders and Schizophrenia for diagnostic evaluation and symptom profiles, 2) drug-free baseline measurements of CSF neurotensin and homovanillic acid, and 3) close monitoring of a therapeutic trial of haloperidol to determine latency of antipsychotic response. RESULTS: A relative deficiency in CSF neurotensin was found in a subgroup of psychotic women whose clinical response to haloperidol was delayed for 11 to 35 days after initiation of the neuroleptic. These patients had greater thought disorder, delusions-hallucinations, behavioral disorganization, and impaired functioning than did psychotic patients with higher CSF concentrations of neurotensin. Neurotensin concentrations increased during treatment with haloperidol. CONCLUSIONS: The study provides further evidence that there is diminished availability of neurotensin in some psychotic patients, with increases in neurotensin early in neuroleptic treatment. Exploration of neurotensin receptor agonists as a potentially novel class of antipsychotic compounds is suggested.

Cerebrospinal fluid concentrations of neurotensin and corticotropin-releasing factor in pediatric patients.

Cerebrospinal fluid (CSF) concentrations of neurotensin (NT) and corticotropin-releasing hormone (CRF)-like immunoreactive materials (LIM) were measured in 22 infants and children 6 days to 15 years of age. For both neuropeptides there was a marked age-related exponential decline in CSF concentrations. The most prominent decrease in CSF neuropeptide concentrations was seen during the first 24 months of postnatal life. From 1 year and on there was no or only minimal age-associated alteration in CSF neuropeptide concentrations. In this group of children (1-15 years) mean CSF concentrations of NT-LIM and CRF-LIM were 36.8 +/- 4.32 and 65.9 +/- 4.63 pg/ml, respectively. As CSF neuropeptide concentrations are apparently independent of circulating serum concentrations, they may reflect functional activity of neuropeptide-containing neurons and therefore may be of value in the assessment of the role of peptides in the human central nervous system function and behavior.

Neurotensin-like immunoreactivity in cerebrospinal fluid of patients with schizophrenia, depression, anorexia nervosa-bulimia, and premenstrual syndrome.

Neurotensin (NT) concentrations in cerebrospinal fluid (CSF) were measured by a sensitive and specific radioimmunoassay in psychiatric patients and age- and sex-matched normal controls. No increase in CSF NT concentrations was observed after antipsychotic drug treatment. CSF NT concentrations were significantly lower in one group of schizophrenic subjects. NT concentrations were unaltered in patients with depression, anorexia/bulimia, or premenstrual syndrome, and no rostral-caudal gradient for NT in CSF was evident. NT concentrations were not related to age or sex, and probenecid treatment did not alter CSF NT concentrations. Finally CSF NT concentrations were unaltered in paranoid schizophrenic subjects. These findings confirm and extend previous studies of CSF NT that showed certain patients with schizophrenia, nonparanoid type, have reduced CSF concentrations of this tridecapeptide.

Reduced CSF neurotensin concentration in drug-free schizophrenic patients.

The concentration of the tridecapeptide neurotensin was measured in CSF from 76 drug-free schizophrenic patients and 45 healthy controls. A highly significant difference was found between the two groups with lower concentration of neurotensin-like immunoreactivity in schizophrenic patients. Normalization of the lower concentrations was obtained in the same patients during ongoing neuroleptic treatment. The neurotensin concentrations in CSF was unrelated to sex, age, duration of the disorder or to previous neuroleptic treatment. Neurotensin levels did not differ between patients with or without a family history. A significant correlation was found between low neurotensin concentrations and decreased motor activity. No significant relationship was seen between the increment in CSF concentrations of neurotensin and clinical improvement during neuroleptic treatment. No significant correlation between CSF concentrations of neurotensin and HVA or 5-HIAA, major metabolites of dopamine and serotonin, respectively, could be demonstrated. However, in a limited number of the schizophrenic patients in this population, a significant correlation was seen between neurotensin and the noradrenaline metabolite MOPEG. The data support the hypothesis that certain schizophrenic patients may have a compromised CNS neurotensin system which might increase vulnerability for this disorder.

Neurotensin-like immunoreactivity (NTLI) concentration in the cerebrospinal fluid of children and its alteration in a febrile aseptic meningitis.

Neurotensin-like immunoreactivity (NTLI) concentrations in the cerebrospinal fluid (CSF) of normal children and patients with febrile aseptic meningitis, aged 7 months to 15 years, were studied. The NTLI concentrations in CSF of 27 children with normal CSF findings were 160.1 +/- 54.6 pg/ml (mean +/- S.D.). The NTLI concentration in CSF of 26 patients in an acute phase of aseptic meningitis was 110.6 +/- 51.1 pg/ml which was significantly (P less than 0.01) lower than the controls. These patients had a mean temperature of 101.4 +/- 1.5 degrees F which remained elevated for an average of 3.5 days. The NTLI concentrations in CSF of 23 patients in a recovery phase (after blood and CSF findings became normal with no fever) were 166.5 +/- 57.8 pg/ml, which did not differ significantly from the normal. There were no statistical correlations between the NTLI concentration in CSF and the protein concentration or total cell count in CSF. These results suggest that NTLI concentration changes during a febrile aseptic meningitis and that it may be associated with thermoregulation.

CSF neuropeptides in euthymic bipolar patients and controls.

Levels of vasopressin, somatostatin, neurotensin, vasoactive intestinal peptide, corticotrophin-releasing factor and adrenocorticotrophin in CSF were determined in lithium-treated and unmedicated euthymic bipolar patients and controls, in a search for a trait marker in affective disorder. No group differences in levels of these peptides were found. Highly significant positive correlations were found among these peptides (with the exception of neurotensin), suggesting that their presence in CSF is functionally significant, as opposed to the result of random diffusion from the interstitial space of the brain.

Cholecystokinin and neurotensin gradients in human CSF.

In successive samples of human lumbar CSF, concentrations of two neurally active peptides, cholecystokinin (CCK) and neurotensin (NT), were compared with levels of homovanillic acid (HVA), the major metabolite of dopamine. Although HVA values progressively increased between the first and 20th milliliter samples, no significant change occurred in the concentration of either peptide. Thus, lumbar CSF levels of CCK and NT, unlike levels of HVA, may not closely reflect amounts of these peptides in supraspinal CSF or brain.