Open AccessTemporal Alterations in Cerebrospinal Fluid Amyloid β-Protein and Apolipoprotein E After Subarachnoid Hemorrhage
Author(s) -
Andrew D. Kay,
Axel Petzold,
Mary Margaret Kerr,
Geoff Keir,
Edward H. Thompson,
James Nicoll
Publication year - 2003
Publication title -
stroke
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.397
H-Index - 319
eISSN - 1524-4628
pISSN - 0039-2499
DOI - 10.1161/01.str.0000100157.88508.2f
Subject(s) - apolipoprotein e , cerebrospinal fluid , medicine , subarachnoid hemorrhage , endocrinology , apolipoprotein b , in vivo , pathology , cholesterol , biology , disease , microbiology and biotechnology
Background and Purpose— The mechanism underlying the association between possession of theAPOE ε4 allele and less favorable outcome after subarachnoid hemorrhage (SAH) remains to be determined. After SAH the level of apolipoprotein E (apoE) in the cerebrospinal fluid (CSF) is decreased, and lower levels are associated with more severe injury and less favorable outcome. This study examined serial CSF samples to determine the time course for the decrease in CSF apoE and the relationship between CSF apoE and amyloid β-protein (Aβ), testing the hypothesis that apoE-Aβ interactions occur in vivo after SAH.Methods— Enzyme-linked immunosorbent assay was used to assay apoE, Aβ1–40 , and Aβ1–42 in serial ventricular CSF samples from 19 patients with SAH and 13 controls. CSF S100B and τ were assayed as surrogate markers of brain injury.Results— There was a sustained decrease in CSF apoE (P <0.001) and Aβ (P <0.001) after SAH in contrast to the observed elevation in CSF S100B (P <0.001) and τ (P <0.001) concentration. There was significant correlation between CSF Aβ concentration and clinical outcome (r =0.65,P <0.01), and the decrease in CSF Aβ concentration correlated significantly with that of apoE (r =0.85,P <0.0001).Conclusions— After SAH both apoE and Aβ levels decrease in the CSF, supporting the concept that interactions between these proteins occur in vivo. The possibility that apoE and Aβ influence outcome after SAH warrants further investigation.