Shimode K, Fujihara S, Nakamura M, Kobayashi S, Tsunematsu T
Third Division of Internal Medicine, Shimane Medical University, Izumo, Japan.
Stroke. 1991 Jul;22(7):860-6. doi: 10.1161/01.str.22.7.860.
An abnormally low level of cystatin C in the cerebrospinal fluid is a diagnostic marker for the hereditary form of brain hemorrhage associated with amyloidosis that was first identified in Iceland. We developed an assay for cystatin C to use in the diagnosis of patients with cerebral amyloid angiopathy and brain hemorrhage. This test consists of a sandwich enzyme-linked immunosorbent assay using monoclonal mouse anticystatin C and polyclonal rabbit anticystatin C antibodies. The cystatin C level was assayed in cerebrospinal fluid samples from 29 patients with brain hemorrhage and 45 control patients with other neurological diseases. Fifteen patients with brain hemorrhage showed low cystatin C levels (less than or equal to 70 ng/ml) in a clinical setting in which the positive and negative findings were compatible with a diagnosis of cerebral amyloid angiopathy. Immunohistological examination of brain tissue obtained by biopsy from two of the 15 patients confirmed the diagnosis of cerebral amyloid angiopathy and identified the deposition of cystatin C and beta-protein. This enzyme-linked immunosorbent assay is simple to perform and may be useful for investigating patients suspected of having cerebral amyloid angiopathy with brain hemorrhage and the deposition of cystatin C.
脑脊液中胱抑素C水平异常降低是与淀粉样变性相关的遗传性脑出血的诊断标志物，该病最初在冰岛被发现。我们开发了一种用于检测胱抑素C的检测方法，以用于诊断患有脑淀粉样血管病和脑出血的患者。该检测由一种夹心酶联免疫吸附测定法组成，使用单克隆小鼠抗胱抑素C抗体和多克隆兔抗胱抑素C抗体。对29例脑出血患者和45例患有其他神经系统疾病的对照患者的脑脊液样本进行了胱抑素C水平检测。在临床环境中，15例脑出血患者的胱抑素C水平较低（小于或等于70 ng/ml），其阳性和阴性结果与脑淀粉样血管病的诊断相符。对这15例患者中的2例进行活检获得的脑组织进行免疫组织学检查，证实了脑淀粉样血管病的诊断，并确定了胱抑素C和β蛋白的沉积。这种酶联免疫吸附测定法操作简单，可能有助于对疑似患有伴有脑出血和胱抑素C沉积的脑淀粉样血管病的患者进行调查。
