Fibrinogen is not elevated in the cerebrospinal fluid of patients with multiple sclerosis.docVIP

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Fibrinogen is not elevated in the cerebrospinal fluid of patients with multiple sclerosis.doc

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Fibrinogen is not elevated in the cerebrospinal fluid of patients with multiple sclerosis

Ehlingetal.FluidsandBarriersoftheCNS2011,8:25 /content/8/1/25 FLUIDS AND BARRIERS OF THE CNS SHORT PAPER OpenAccess Fibrinogenisnotelevatedinthecerebrospinal fluidofpatientswithmultiplesclerosis RainerEhling1*,FranziskaDiPauli1,PeterLackner1,BettinaKuenz1,WolframSantner2,AndreasLutterotti1, ClaudiaGneiss1,HaraldHegen1,MichaelSchocke2,FlorianDeisenhammer1,ThomasBerger1andMarkusReindl1 Abstract Background:Elevatedplasmafibrinogenlevelsareawellknownfindinginacuteinfectiousdiseases,acutestroke andmyocardialinfarction.Howeveritsroleinthecerebrospinalfluid(CSF)ofacuteandchroniccentral(CNS)and peripheralnervoussystem(PNS)diseasesisunclear. Findings:WeanalyzedCSFandplasmafibrinogenlevelstogetherwithroutineparametersinpatientswith multiplesclerosis(MS),acuteinflammatorydiseasesoftheCNS(bacterialandviralmeningoencephalitis,BMand VM)andPNS(Guillain-Barrésyndrome;GBS),aswellasinnon-inflammatoryneurologicalcontrols(OND)inatotal of103patients.Additionally,MSpatientsunderwentcerebralMRIscansattimeoflumbarpuncture. CSFandplasmafibrinogenlevelsweresignificantlylowerinpatientswithMSandONDpatientsascomparedto patientswithBM,VMandGBS.Therewasaclosecorrelationbetweenfibrinogenlevelsandalbuminquotient(rho =0.769,p0.001)whichstronglysuggestspassivetransferoffibrinogenthroughtheblood-CSF-barrierduring acuteinflammation.Hence,inMS,theprototypeofchronicneuroinflammation,CSFfibrinogenlevelswerenot elevatedandcouldnotbecorrelatedtoclinicalandneuroradiologicaloutcomeparameters. Conclusions:AlthoughpreviousworkhasshownclearevidenceoftheinvolvementoffibrinogeninMS pathogenesis,thisisnotaccompaniedbyincreasedfibrinogenintheCSFcompartment. Keywords:blood-CSFbarrier(BCSFB),cerebrospinalfluid(CSF),centralnervoussystem(CNS),fibrinogen, neuroinflammation Background determinationoffibrinogenincerebrospinalfluid(CSF) Fibrinogen is a soluble 340 kDa dimeric glycoprotein has so far been restricted to descriptions of elevated thatissynthesizedintheliver,secretedintotheplasma fibrinogen degradation