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EN
Three monoclonal antibodies specific to the central cell-binding and the C- and N-terminal domains of fibronectin (FN) were used to test antigenic epitope accessibility on human plasma and cerebrospinal fibronectins. In the plasma group, the mean N-terminal FN domain immunoreactivity was about one fourth that of the cell-binding and C-terminal domains, whereas in cerebrospinal fluid they were nearly equal. In the presence of 0.5-6 M urea N-terminal domain immunoreactivity in the plasma increased 3-6-fold, but it decreased 0.7-3-fold in the cerebrospinal fluid. Analysis of fibronectin domain immunoreactivities of the cell-binding and N-terminal domains by a panel of specific monoclonal antibodies may reveal N-terminal fibronectin domain accessibility for reaction with biological partner ligand(s) and/or processes in which FN could be implicated. Such determinations may have important clinical implications.
EN
Introduction. Creutzfeldt-Jakob disease (CJD) is a rare and fatal neurodegenerative disease of the central nervous system which is caused by an infectious protein called prion. Multiple forms of CJD have been classified including sporadic (more than 90% cases), familial, iatrogenic and variant type of disease. CJD, especially in its early stages, is a highly challenging illness to diagnose. Aim. Article aims to present cases of Creutzfeldt-Jackob disease with early symptoms of rapidly progressing dementia at the initial stage of CJD. Description of the cases. This paper describes two cases of patients with suspected CJD with a history of rapidly progressive dementia admitted to the Department of Neurology, MSWiA Hospital in Rzeszów. Conclusion. Despite the fact that CJD is an incurable illness and there is no cure guaranteeing recovery, it is important to make the right diagnosis. Assay of 14-3-3 protein in cerebrospinal fluid is a sensitive and specific marker which is helpful in the diagnosis of CJD. The only relevant method of correctly confirming a diagnosis of this disease is by performing a brain biopsy.
EN
A large body of evidence has implicated prostaglandin E2 (PGE2) in fever production. However, the role of PGD2 in this context is only poorly understood. We therefore determined by LC-MS/MS analyses the content of PGD2 and PGE2 in cerebrospinal fluid (CSF), plasma and lungs of rats over 5 hours after fever induction by intraperitoneal injection of lipopolysaccharide (LPS, 50 µg/kg). Both PGD2 and PGE2 were detected in CSF, plasma and lungs of saline-treated control animals. The injection of LPS evoked fever and an increase of PGE2 in the CSF, while the CSF content of PGD2 was not significantly altered. However, both PGE2 and PGD2 levels were elevated in plasma and lungs after LPS injection. Interestingly, pretreatment with a novel selective inhibitor of hematopoietic prostaglandin D synthase (H-PGDS), EDJ300520 (10-40 mg/kg p.o.), selectively and dose-dependently prevented the LPS-induced increase of PGD2 in plasma and lungs but did not affect the PGE2 content. Most remarkably, EDJ300520 pretreatment led to an hypothermic response after LPS injection during the first 3 h and prevented fever induction. These data indicate that PGD2 produced peripherally by H-PGDS essentially contributes to LPS-induced fever.
EN
The work presented here demonstrates the utility of Caco-2 cells in the isolation of enteroviruses (EVs) from environmental and clinical materials. Thirty-two samples of cerebrospinal fluid positive in Pan-entero RT-PCR were taken for EV strain isolation in cell culture. Out of the 32 samples analysed, 22 (68.75%) were positive for enteroviruses by isolation in Caco-2 cells, and 10 (31.25%) were positive by isolation in RD cells. High viral titre in clinical specimens resulted in rate increase for isolation in Caco-2 cells and RD cells (87.5% and 50%, respectively). Also, the probability of isolation of enteroviruses from sewage in Caco-2 cells was 20 times higher that in RD cells. We proved that Caco-2 cells were more effective than RD cells in enterovirus isolation, irrespective of the material used in the inoculation process.
EN
Matrix metalloproteinases (MMPs) are implicated in the pathogenesis of motor neuron degeneration in amyotrophic lateral sclerosis (ALS) and might be potential markers of diagnosis, prognosis and monitoring treatment effects. The aim of the present study was evaluation of the MMPs significance in cerebrospinal fluid (CSF MMPs) of patients with ALS in relation to severity of the disease. Metalloproteinases MT-MMP-1, MMP-2, MMP-9 and additionally age of subjects and disease duration were analyzed. The results demonstrate that the error of differentiation between healthy subjects and ALS patients (for MMP-2 feature) as well as between mild and severe ALS states (for CSF MMPs set) equalled to 0.033. In conclusion, the pattern recognition approach may be useful for differentation of ALS progressing on the basis of CSF MMPs features.
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EN
Creutzfeldt-Jakob disease (CJD) belongs to a group of transmissible spongiform encephalopathies in which neuropathological confirmation is needed for a definite diagnosis. Based on clinical symptoms, the disease can be characterized only as possible or probable. The diagnostic criteria for sporadic CJD (sCJD) approved by the World Health Organization include 14-3-3 protein as a marker detectable in the cerebrospinal fluid (CSF). Since 2010, also magnetic resonance FLAIR or DWI imaging has been included in the criteria for sCJD. 14-3-3 protein is a normal neuronal protein released to the CSF as a result of extensive neuronal damage. As it is a non-specific marker, a positive result gives no information about the reason of the neuronal death. The test for 14-3-3 protein is useful only when considered in an appropriate clinical context, together with other diagnostic criteria. In certain conditions, false negative as well as false positive results are possible. The 14-3-3 protein is detected in about 90% of sporadic CJD cases, whereas the result is positive in only 50% of variant CJD patients, therefore this analysis is less useful in the diagnostics of vCJD.
PL
Choroba Creutzfeldta-Jakoba (CJD) należy do grupy chorób wywoływanych przez priony, w których do ustalenia definitywnego rozpoznania konieczne jest badanie neuropatologiczne mózgu. Przyżyciowo można chorobę zdiagnozować jako możliwą lub prawdopodobną, zgodnie z kryteriami zalecanymi przez Światową Organizację Zdrowia. W kryteriach diagnostycznych dla sporadycznej postaci CJD (sCJD) uwzględniono marker biochemiczny – dodatni wynik testu na obecność białka 14-3-3 w płynie mózgowo-rdzeniowym. W nowych zmodyfikowanych kryteriach dla sCJD, obowiązujących od 2010 roku, znajduje się również badanie mózgu metodą rezonansu magnetycznego wykonanego w sekwencji FLAIR lub DWI. Białka z grupy 14-3-3 są prawidłowymi białkami neuronalnymi, uwalnianymi do płynu mózgowo-rdzeniowego na skutek obumierania komórek, jest to zatem nieswoisty marker śmierci neuronów. Czułość testu na obecność białka 14-3-3 może być wysoka, zależy jednak od podtypu molekularnego, tempa rozwoju choroby i etapu choroby, na którym wykonano nakłucie lędźwiowe. Dodatni wynik testu pozwala na zmianę klasyfikacji choroby z możliwej na prawdopodobną, ale tylko w połączeniu z innymi kryteriami diagnostycznymi. Rozpatrywanie wyniku – zarówno ujemnego, jak dodatniego – w oderwaniu od kontekstu klinicznego może wprowadzać w błąd. Białko 14-3-3 wykrywa się w około 90% przypadków sCJD oraz jedynie w 50% przypadków wariantu CJD (vCJD), zatem w vCJD badanie posiada dużo mniejsze znaczenie.
EN
Thyroid hormones (THs) are obligatory for transition from breeding season to anestrus in sheep. In this process, THs act during a very limited time of the year and primarily within the brain. In ewes chronically equipped for sampling cerebrospinal fluid (CSF) from the third ventricle, we have characterized the concentrations of total and free thyroxine (T4), triiodothyronine (T3), and total reverse T3 (rT3) in the CSF during breeding season, anestrus and during a critical period required for transition to anestrus (December-March). The total T4, T3, rT3 and free T3 average concentrations (± SEM) in CSF were 1.5 ± 0.07 ng/ml, 14.5 ± 1.2 pg/ml, 43 ± 7.4 pg/ml, and 0.6 ± 0.05 pg/ml, respectively, and all were significantly lower (p < 0.001) than in blood plasma except free T4 (12.6 ± 1.1 pg/ml), which was similar to that in plasma. There was a seasonal trend (p < 0.05) in the concentration of total T3 (highest in December) and free T4 (highest in November) in the CSF that does not follow that in blood plasma. During the period of transition to anestrus the CSF total T3/TT4 molar ratio and free T3/ T4 ratio were significantly lower (p < 0.05 and p < 0.01, respectively) than in blood plasma, while the total rT3/T4 ratio was significantly higher (p < 0.01) at the end of this period (March). Additionally, the CSF total rT3 concentrations were also significantly correlated with the CSF total T4 levels (r = 0.57; p < 0.05). In conclusion, the CSF in sheep may serve as a considerable source of thyroid hormones for neuroendocrine events. The lack of significant changes in THs concentrations in the CSF during the period of transition to anestrus indicate that neither seasonal changes of THs circulating in the blood plasma nor THs circulating in the CSF actively drive the transition to anestrus.
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EN
The aim of this study was applications of cerebrospinal fluid (CSF) NMR-based metabolic fingerprinting to amyotrophic lateral sclerosis (ALS) as possible early diagnostic tool. Two CSF sample categories were collected: 9 ALS patients and 13 age-matched control patients (without neurological disease). Metabolic profile of the CSF was determined by high resolution proton NMR spectroscopy. For statistical analysis magnitudes of 33 signals of the NMR spectrum were selected. Partial least square discriminant analysis (PLS-DA) and orthogonal PLS-DA (OPLS-DA) modeling were used to find potential biomarkers of the disease. Those analyses showed that it was possible to distinguish the ALS patients from the control ones on the basis of the CSF metabolic profile. Significantly higher levels of metabolites observed in the patients with ALS may represent the state of anaerobic metabolism and excitotoxicity.
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Content available Diagnostyka różnicowa stwardnienia rozsianego
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EN
Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system (CNS). It affects usually young people between 20 and 40 years of age, predominantly women. According to Lublin and Riengold classification there are four major clinical patterns of MS course: remitting-relapsing, primary progressive, secondary progressive and progressive-relapsing. Making definite diagnosis of MS is becoming recently very important because of development of some new immunomodulatory therapies of MS with proven effectiveness when used at the early stage of the disease. Because of the huge diversity of MS clinical signs and symptoms as well as the course of the disease, there are several other diseases with similar clinical picture. Differential diagnosis of MS includes such disease as: acute disseminated encephalomyelitis (ADEM), neuroboreliosis, neurosarcoidosis, systemic lupus erythematosus (SLE), Sjögren’s syndrome, CNS vasculitis, Behçet’s disease, antiphospholipid syndrome and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Very important in MS differential diagnosis are some laboratory findings. The most useful techniques are magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) examination, visual evoked potentials (VEP) and some blood tests. They often facilitate differential diagnosis of MS at the early stage of the disease. This is very important because the proper treatment can be initiated early.
PL
Stwardnienie rozsiane (łac. sclerosis multiplex, SM) jest przewlekłą chorobą zapalno-demielinizacyjną ośrodkowego układu nerwowego (OUN). Występuje głównie u osób młodych, a najwięcej zachorowań odnotowuje się w wieku 20-40 lat. Wyróżniamy cztery typy przebiegu klinicznego wg klasyfikacji Lublina i Reingolda: postać rzutowo-remisyjną, postać pierwotnie postępującą, postać wtórnie postępującą oraz postać postępująco-nawracającą. Diagnostyka różnicowa SM, a w szczególności ustalenie ostatecznego rozpoznania tej choroby, nabiera w ostatnim czasie dużego znaczenia, co wiąże się z pojawieniem się terapii immunomodulujących i udowodnionymi korzyściami dla pacjentów, u których zastosowano to leczenie we wczesnej fazie choroby. W związku z dużą różnorodnością oraz zmiennością objawów i przebiegu klinicznego, zwłaszcza we wczesnym okresie choroby czy też w przypadkach nietypowych, SM tę należy różnicować z wieloma innymi chorobami o podobnym przebiegu i obrazie klinicznym. Stwardnienie rozsiane wymaga przede wszystkim różnicowania z następującymi chorobami: ostrym rozsianym zapaleniem mózgu i rdzenia (ADEM), neuroboreliozą, neurosarkoidozą, toczniem układowym z zajęciem układu nerwowego (SLE), zespołem Sjögrena, zapaleniem naczyń, chorobą Behçeta, zespołem antyfosfolipidowym czy autosomalnie dominującą arteriopatią naczyń mózgowych z udarami podkorowymi i leukoencefalopatią (CADASIL). Ze względu na zbliżony obraz kliniczny wszystkich ww. chorób bardzo przydatne w diagnostyce różnicowej są niektóre badania dodatkowe, które czasami ułatwiają postawienie właściwej diagnozy już we wczesnej fazie choroby. Ma ona duże znaczenie, ponieważ umożliwia rozpoczęcie właściwego dla danej jednostki leczenia.
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