Nejvíce citovaný článek - PubMed ID 11605255
Cerebrospinal fluid
Laboratory analysis of basic cerebrospinal fluid (CSF) parameters is considered as essential for any CSF evaluation. It can provide rapidly very valuable information about the status of the central nervous system (CNS). Our retrospective study evaluated parameters of basic CSF analysis in cases of either infectious or non-infectious CNS involvement. Neutrophils are effector cells of innate immunity. Predominance of neutrophils was found in 98.2% of patients with purulent inflammation in CNS. Lymphocytes are cellular substrate of adaptive immunity. We found their predominance in 94.8% of patients with multiple sclerosis (MS), 66.7% of patients with tick-borne encephalitis (TBE), 92.2% of patients with neuroborreliosis, 83.3% of patients with inflammatory response with oxidative burst of macrophages in CNS and 75.0% of patients with malignant infiltration of meninges (MIM). The simultaneous assessment of aerobic and anaerobic metabolism in CSF using the coefficient of energy balance (KEB) allows us to specify the type of inflammation in CNS. We found predominantly aerobic metabolism (KEB > 28.0) in 100.0% CSF of patients with normal CSF findings and in 92.8% CSF of patients with MS. Predominant faintly anaerobic metabolism (28.0 > KEB > 20.0) in CSF was found in 71.8% patients with TBE and in 64.7% patients with neuroborreliosis. Strong anaerobic metabolism (KEB < 10.0) was found in the CSF of 99.1% patients with purulent inflammation, 100.0% patients with inflammatory response with oxidative burst of macrophages and in 80.6% patients with MIM. Joint evaluation of basic CSF parameters provides sufficient information about the immune response in the CSF compartment for rapid and reliable diagnosis of CNS involvement.
Extravasation of blood in the central nervous system (CNS) represents a very strong damaged associated molecular patterns (DAMP) which is followed by rapid inflammation and can participate in worse outcome of patients. We analyzed cerebrospinal fluid (CSF) from 139 patients after the CNS hemorrhage. We compared 109 survivors (Glasgow Outcome Score (GOS) 5-3) and 30 patients with poor outcomes (GOS 2-1). Statistical evaluations were performed using the Wilcoxon signed-rank test and the Mann-Whitney U test. Almost the same numbers of erythrocytes in both subgroups appeared in days 0-3 (p = 0.927) and a significant increase in patients with GOS 2-1 in days 7-10 after the hemorrhage (p = 0.004) revealed persistence of extravascular blood in the CNS as an adverse factor. We assess 43.3% of patients with GOS 2-1 and only 27.5% of patients with GOS 5-3 with low values of the coefficient of energy balance (KEB < 15.0) in days 0-3 after the hemorrhage as a trend to immediate intensive inflammation in the CNS of patients with poor outcomes. We consider significantly higher concentration of total protein of patients with GOS 2-1 in days 0-3 after hemorrhage (p = 0.008) as the evidence of immediate simultaneously manifested intensive inflammation, swelling of the brain and elevation of intracranial pressure.
Brain ischemia after central nervous system (CNS) bleeding significantly influences the final outcome of patients. Catalytic activities of aspartate aminotransferase (AST) in the cerebrospinal fluid (CSF) to detect brain ischemia were determined in this study. The principal aim of our study was to compare the dynamics of AST in 1956 CSF samples collected from 215 patients within a 3-week period after CNS hemorrhage. We compared concentrations of the AST catalytic activities in the CSF of two patient groups: survivors (Glasgow Outcome Score (GOS) 5-3) and patients in a vegetative state or dead (GOS 2-1). All statistical evaluations were performed using mixed models and the F-test adjusted by Kenward and Roger and the Bonferroni adjustment for multiple tests. The significantly higher catalytic activities of AST in the CSF from patients with the GOS of 2-1 when compared to those who survived (GOS 5-3, p = 0.001) were found immediately after CNS haemorrhage. In the further course of time, the difference even increased (p < 0.001). This study confirmed the key association between early signs of brain damage evidenced as an elevated AST activity and the prediction of the final patient's clinical outcome. The study showed that the level of AST in the CSF could be the relevant diagnostic biomarker of the presence and intensity of brain tissue damage.
- Klíčová slova
- CNS haemorrhage, aspartate aminotransferase, brain tissue injury, cerebrospinal fluid,
- Publikační typ
- časopisecké články MeSH
Diseases of the central nervous system (CNS) mean for the human organism a potentially dangerous situation. An investigation of cerebrospinal fluid (CSF) provides important information about a character of CNS impairment in the decision-making diagnostic and therapeutic algorithm. The authors present a brief overview of available cerebrospinal fluid assays, shortened indication criteria, a recommended algorithm of CSF assessment in different suspected diseases, and a view of the external quality system. The whole portfolio of obtainable CSF methodology is further subdivided according to the adequate choice into the first and inevitable basic routine panel, and following complicated analyses of highly specialized character. The basic panel is considered for standard laboratories, the complete specialized assessment should be provided by a super-consulting laboratory.
- MeSH
- algoritmy MeSH
- cytologické techniky MeSH
- klinické laboratorní techniky MeSH
- lidé MeSH
- makrofágy MeSH
- mozkomíšní mok chemie cytologie MeSH
- proteiny v mozkomíšním moku analýza MeSH
- směrnice pro lékařskou praxi jako téma * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- proteiny v mozkomíšním moku MeSH
Beta2-Microglobulin ( β 2-m) is a low molecular weight protein occurring in all body fluids. Its concentration increases in various pathologies. Increased values in cerebrospinal fluid (CSF) are ascribed to an activation of immune system. Using immunoturbidimetry, we examined concentrations of beta2-microglobulin in cerebrospinal fluid in a large group of 6274 patients with defined neurological diseases. Cell counts, total protein, albumin, glucose, lactic acid, immunoglobulins concentrations, and isofocusing (IEF) were also evaluated. We found substantial changes of CSF β 2-m concentrations in purulent meningitis, leptomeningeal metastasis, viral meningitis/encephalitis, and neuroborreliosis, while in multiple sclerosis these changes were not significant. Intrathecal synthesis and immune activation were present in these clinical entities. A new normative study enables better understanding of beta2-microglobulin behavior in CSF.
- MeSH
- beta-2-mikroglobulin mozkomíšní mok MeSH
- biologické markery mozkomíšní mok MeSH
- dítě MeSH
- dospělí MeSH
- infekce bakteriemi rodu Borrelia mozkomíšní mok diagnóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- meningeální nádory mozkomíšní mok diagnóza sekundární MeSH
- meningitida bakteriální mozkomíšní mok diagnóza MeSH
- meningitida virová mozkomíšní mok MeSH
- mladiství MeSH
- mladý dospělý MeSH
- předškolní dítě MeSH
- roztroušená skleróza mozkomíšní mok diagnóza MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- studie případů a kontrol MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- předškolní dítě MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- beta-2-mikroglobulin MeSH
- biologické markery MeSH
Urgent examination of cerebrospinal fluid (CSF) provides immediate important information about the character of central nervous system (CNS) impairment. Although this examination includes energy parameters such as glucose and lactate concentrations, it does not commonly use Coefficient of Energy Balance (CEB). In this study, we focused on CEB because it enables more exact assessment of actual energy state in the CSF compartment than glucose and lactate alone. CEB informs about the actual functioning condition of present cells, and it does not require any other analysis or costs. Using Kruskal-Wallis ANOVA, we examined a large CSF sample (n = 8183) and we compared CEB values among groups with different cytological syndromes. We found a statistically significant difference of CEB between the group with granulocyte pleocytosis and the control group. These results indicate a high degree of anaerobic metabolism caused by the oxidative burst of neutrophils. Similarly, we found a statistically significant difference of CEB between the control group and groups with tumorous oligocytosis plus pleocytosis and monocyte pleocytosis. This difference can be attributed to the oxidative burst of macrophages. Our findings suggest that CEB combined with CSF cytology has a great importance for diagnosis, differential diagnosis, and early therapy of CNS diseases.
- MeSH
- časná diagnóza * MeSH
- diferenciální diagnóza MeSH
- energetický metabolismus * MeSH
- fagocyty metabolismus patologie MeSH
- lidé MeSH
- nádory centrálního nervového systému mozkomíšní mok metabolismus MeSH
- nemoci centrálního nervového systému mozkomíšní mok diagnóza metabolismus MeSH
- referenční hodnoty MeSH
- respirační vzplanutí MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
A routine diagnostic procedure of cryptococcal meningitis using Alcian Blue and Nuclear Fast Red staining is described in a group of 16 patients. Cerebrospinal fluid findings, including clinical cytology, routine biochemistry and protein fractions, are presented.
- MeSH
- barvení a značení metody MeSH
- Cryptococcus neoformans izolace a purifikace MeSH
- kryptokoková meningitida diagnóza mikrobiologie MeSH
- lidé MeSH
- mikrobiologické techniky metody MeSH
- mikroskopie metody MeSH
- mozkomíšní mok mikrobiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
A very rare clinical entity, so-called eosinophilic meningitis, classified by prevalence of eosinophils in cerebrospinal fluid (CSF), with the presence of pleiocytosis, has been recorded in our laboratory four times only in the last 24 years. A low glucose level, elevation of total protein and lactic acid in CSF were detected in all the clinical cases. The last two cases were made possible by using flow cytometry method; surprisingly, the presence was found in mature T-cells in CSF, predominantly helpers (CD3+, CD4+) and, practically, none is B-cells (CD19+), plasma cells (CD138+) and NK-cells.
- MeSH
- eozinofily imunologie MeSH
- glukosa mozkomíšní mok MeSH
- krevní proteiny mozkomíšní mok MeSH
- kyselina mléčná mozkomíšní mok MeSH
- lidé MeSH
- meningitida mozkomíšní mok diagnóza imunologie MeSH
- počet leukocytů MeSH
- průtoková cytometrie MeSH
- T-lymfocyty pomocné-indukující imunologie MeSH
- T-lymfocyty imunologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- glukosa MeSH
- krevní proteiny MeSH
- kyselina mléčná MeSH
The levels of prealbumin (PAB, transthyretin) were determined and evaluated in the cerebrospinal fluid (CSF) and serum in various subgroups of the multiple sclerosis (MS) patients. In severely disabled patients, serum PAB was elevated more frequently. CSF and serum PAB concentrations were higher in treated than in nontreated patients; the values above the upper reference limits were also more frequently found in treated patients. PAB index showed a tendency to decrease during the course of the disease. The routine determination of PAB in CSF and serum is, therefore, recommended to be recognized in MS patients as a substantial clinical value and, thus, be comprised, including also immunoglobulins and other parameters, into the spectrum of characteristics in Protein Panel.
- MeSH
- lidé MeSH
- prealbumin analýza mozkomíšní mok MeSH
- roztroušená skleróza krev mozkomíšní mok patologie MeSH
- stupeň závažnosti nemoci MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Názvy látek
- prealbumin MeSH
Sixty-five samples of cerebrospinal fluid (CSF) were evaluated using an automated cytoflow method with the CD-Sapphire hematology analyzer in order to investigate possible relationships between cell population patterns and diagnostic groups and better understand the biology of neurological disease. A basic panel of CD markers, including CD3/4/8/19/138/HLA-DR, was used to analyze CSF samples from clinical and laboratory confirmed cases of multiple sclerosis, neuroborreliosis, viral and bacterial neuroinfective diseases, malignant infiltrations of meninges and scavenger macrophagic reactions of the central nervous system. The principles of immune response and the contribution of cytological 'disease-related patterns' for these nosological entities are described. The distinct patterns of lymphocyte subpopulations in neuroborreliosis appear to be characteristic and could possibly serve as diagnostic indicators. Further verification and research will be necessary to clarify the significance and nature of CD4+ CD8+ positive subset in cerebrospinal fluid.
- MeSH
- CD antigeny mozkomíšní mok imunologie MeSH
- encefalitida virová imunologie MeSH
- lidé MeSH
- lymská neuroborelióza imunologie MeSH
- meningitida virová imunologie MeSH
- monoklonální protilátky imunologie MeSH
- mozkomíšní mok cytologie imunologie MeSH
- nemoci centrálního nervového systému mozkomíšní mok diagnóza imunologie MeSH
- podskupiny lymfocytů cytologie imunologie MeSH
- průtoková cytometrie metody MeSH
- roztroušená skleróza imunologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- hodnotící studie MeSH
- Názvy látek
- CD antigeny MeSH
- monoklonální protilátky MeSH
