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
• Algorithms MeSH
• Cytological Techniques MeSH
• Clinical Laboratory Techniques MeSH
• Humans MeSH
• Macrophages MeSH
• Cerebrospinal Fluid chemistry   cytology   MeSH
• Cerebrospinal Fluid Proteins analysis   MeSH
• Practice Guidelines as Topic * MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH
• Names of Substances
• Cerebrospinal Fluid Proteins MeSH

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. Autoimmune inflammation is common in the early stages of MS. This stage is followed by the neurodegenerative process. The result of these changes is axon and myelin breakdown. Although MS is according to McDonald's revised diagnostic criteria primarily a clinical diagnosis, paraclinical investigation methods are an important part in the diagnosis of MS. In common practice, magnetic resonance imaging of the brain and spinal cord, examination of cerebrospinal fluid (CSF) and examination of visual evoked potentials are used. There are an increasing number of studies dealing with biomarkers in CSF and their role in the diagnosis and treatment of MS. We hypothesized that the levels of some markers could be changed in MS in comparison with controls. We studied five inflammatory markers [interleukin-6 (IL-6), interleukin-8, interleukin-10 (IL-10), beta-2-microglobulin, orosomucoid]. CSF and serum levels of inflammatory markers were assessed in 38 patients with newly diagnosed MS meeting McDonald's revised diagnostic criteria and in 28 subjects as a control group (CG). Levels of beta-2-microglobulin and interleukin-8 in CSF were found to be significantly higher in MS patients in comparison to CG (p < 0.001 resp. p = 0.007). No differences in other CSF markers (IL-6, IL-10 and orosomucoid) and serum levels of all markers between both groups were found. The levels of two studied inflammatory markers were found to be increased at the time of first clinical symptoms of MS. Research on the role of inflammatory and neurodegenerative markers in MS should continue.

• MeSH
• beta 2-Microglobulin blood   cerebrospinal fluid   MeSH
• Cytokines cerebrospinal fluid   MeSH
• Adult MeSH
• Immunoassay MeSH
• Middle Aged MeSH
• Humans MeSH
• Statistics, Nonparametric MeSH
• Orosomucoid metabolism   MeSH
• Pilot Projects MeSH
• Multiple Sclerosis blood   cerebrospinal fluid   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• beta 2-Microglobulin MeSH
• Cytokines MeSH
• Orosomucoid 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
• Humans MeSH
• Prealbumin analysis   cerebrospinal fluid   MeSH
• Multiple Sclerosis blood   cerebrospinal fluid   pathology   MeSH
• Severity of Illness Index MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Publication type
• Journal Article MeSH
• Comparative Study MeSH
• Names of Substances
• Prealbumin MeSH

Selected cerebrospinal-fluid (CSF) parameters (intrathecal synthesis of Borrelia-specific antibodies, oligoclonal IgG bands, CSF-to-serum quotient of albumin as a marker of blood-CSF barrier function and cytology) and typical CSF profile in neuroborreliosis were evaluated with the aim of elucidating possible clinical and laboratory similarities of neuroborreliosis (NB) and other neurological diseases (OND). From the cohort of 58 patients (38 diagnosed for NB, 20 with OND) NB patients had positive Borrelia-specific IgG antibodies in 97 % and positive Borrelia-specific IgM antibodies in 55 %; oligoclonal IgG bands were detected in 55%. The blood-CSF barrier was impaired in 89%, positive cytology was detected in 97% of the NB patients. Evaluation of specific intrathecal synthesis improves CSF diagnosis of NB, therefore, a combined CSF analysis has to be considered along with the clinical picture and medical history when formulating the diagnosis of NB.

• MeSH
• Borrelia burgdorferi Group * immunology   MeSH
• Diagnosis, Differential MeSH
• Blood-Brain Barrier MeSH
• Histocytochemistry MeSH
• Immunoglobulin G cerebrospinal fluid   MeSH
• Immunoglobulin M cerebrospinal fluid   MeSH
• Humans MeSH
• Lyme Neuroborreliosis cerebrospinal fluid   diagnosis   MeSH
• Cerebrospinal Fluid * chemistry   cytology   immunology   MeSH
• Nervous System Diseases cerebrospinal fluid   diagnosis   MeSH
• Antibodies, Bacterial cerebrospinal fluid   MeSH
• Serum Albumin cerebrospinal fluid   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• Immunoglobulin G MeSH
• Immunoglobulin M MeSH
• Antibodies, Bacterial MeSH
• Serum Albumin MeSH

In a group of 10,156 patients with neurological diseases, the IgM level was assessed (using laser nephelometry) both in cerebrospinal fluid (CSF) and serum; concentration of other 17 protein fractions was also simultaneously determined: albumin, immunoglobulins, acute phase reactants, complement components, apolipoproteins, proteinase inhibitors and alpha1-microglobulin. Total protein, element counts and glucose level were also evaluated. In patients with normal CSF findings, only limited statistically significant correlations were demonstrated between IgM and other CSF protein fractions while, in the group of patients with pathological CSF findings, significant correlations were found between CSF(IgM) and other immunoglobulins, complement fractions and the rate of intrathecal synthesis of immunoglobulins. Correlations were also found between CSF(IgM) and CSF antithrombin-III and alpha1-microglobulin. Correlations between CSF(IgM) and CSF apolipoproteins support the theory of CNS tissue destruction whenever the concentration of CSF apolipoproteins is elevated. Our data substantially contribute to establishing the diagnosis in patients with neurological diseases; simultaneous measurement of a high number of CSF proteins is becoming inevitable for a reasonable assessment of the CSF Protein Status.

• MeSH
• Biomarkers MeSH
• Immunoglobulin M blood   cerebrospinal fluid   MeSH
• Humans MeSH
• Linear Models MeSH
• Cerebrospinal Fluid chemistry   cytology   immunology   MeSH
• Nervous System Diseases blood   cerebrospinal fluid   immunology   MeSH
• Predictive Value of Tests MeSH
• Cerebrospinal Fluid Proteins chemistry   MeSH
• Inflammation MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• Biomarkers MeSH
• Immunoglobulin M MeSH
• Cerebrospinal Fluid Proteins MeSH