Diagnostic use of cerebral and extracerebral oxysterols

PubMed · PMID 15061359

Clin Chem Lab Med. 2004 Feb;42(2):186-91

Leoni V, Masterman T, Mousavi FS, Wretlind B, Wahlund LO, Diczfalusy U, Hillert J, Bjorkhem I.

Department of Experimental and Clinical Biomedical Science (DSBSC), University of Insubria, Varese, Italy.

BACKGROUND:

24S-Hydroxycholesterol (24OHC) and 27-hydroxycholesterol (27OHC) are two structurally similar oxysterols of different origins--the former almost exclusively formed in the brain and the latter formed to a lesser extent in the brain than in most other organs.

HYPOTHESIS TO BE TESTED:

Neuronal damage and/or demyelination causes increased flux of 24OHC from the brain into the cerebrospinal fluid (CSF), whereas a defect blood-brain barrier causes increased flux of 27OHC from the circulation into the CSF.

METHODS:

Isotope dilution-mass spectrometry was used to assay the two oxysterols in CSF and plasma from more than 250 patients with different neurological and geriatric diseases.

RESULTS:

The CSF-levels of the two oxysterols were much more affected by the different diseases than the plasma levels.

Patients with active demyelinating diseases had increased levels of 24OHC in CSF with a relatively high 24OHC/27OHC ratio.

Patients with meningitis in general had high levels of both steroids with a low 24OHC/27OHC ratio.

Patients with Alzheimer's disease had slightly increased levels of 24OHC in CSF with less increase in 27OHC.

Patients with multiple sclerosis had a tendency to have higher levels of 24OHC during active periods with a high 24OHC/ 27OHC ratio.

CONCLUSIONS:

Measurements of the two oxysterols in CSF and plasma may add significantly to existing biochemical methods for evaluation of neurological diseases.