The Determination of Serum and Cerebrospinal Fluid Clusterine Utilized in the Diagnostics of the CNS Affection – A Pilot Study

Czech version

Authors: D. Stejskal ¹; J. Vavroušková ²; J. Mareš ³; M. Karpíšek ⁴
Authors‘ workplace: Oddělení laboratorní medicíny Nemocnice Šternberk p. o. ¹; Neurologické oddělení Nemocnice Šternberk p. o. ²; Neurologická klinika FN Olomouc ³; Veterinární a farmakologická fakulta Brno ⁴
Published in: Cesk Slov Neurol N 2007; 70/103(1): 62-66
Category: Short Communication

Overview

Recently, there has appeared information concerning the possibility of determining the presence and extent of the brain disorder by means of examining selected parameters in the cerebrospinal fluid (CSF) or blood. One of these potential indices could be clusterine, an apoptosis inhibitor.

The study was aimed at the determination of the diagnostic effectiveness of examining clusterine in serum and CSF of patients with their CNS involvement.

Thirty-eight probands underwent the examination. The subjects were divided into two groups according to the presence of the CNS affection due to various causes (without/with involvement). Cerebral CT examination, lumbar puncture with morphological and biochemical investigations of CSF and determining the indices of albumins, immunoglobulins, cystatine and clusterine were carried out in all the probands. Subjects with signs of the CNS involvement showed higher concentrations of clusterine in CSF and its index in comparison with probands without the CNS affection (medians of clusterine, or index Csf/S 5760 vs 3435, p = 0.034 vs 0.023, p < 0.01). There were revealed significant correlations between CSF clusterine and indices of albumin (r = 0.58, p = 0.021), immunoglobulin G (r = 0.66, p = 0.008), immunoglobulin M (r = 0.24, p = 0.047), immunoglobulin A (r = 0.66, p = 0.008), and cystatine C in CSF ( r = 0.43, p = 0.022). After the classification of patients based on the presence of CNS disorder, it was found out that the determination of clusterine in CSF had the sensitivity of 79 % and specificity of 86 % at the value of clusterine > 4230 kU/l, and the sensitivity of clusterine index was 65 % and specificity 93 % at the value > 0.03 kU/l.

Clusterine seems to be a promising laboratory index of a damage to the brain cells with satisfactory diagnostic effectiveness. After verifying these data in larger trials, it could be used even in routine diagnostics.

Key-words:
clusterine, clusterine index, brain disorder, liquor, serum

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