Laurent U B, Laurent T C, Hellsing L K, Persson L, Hartman M, Lilja K
Department of Ophthalmology, University of Uppsala, Sweden.
Acta Neurol Scand. 1996 Sep;94(3):194-206. doi: 10.1111/j.1600-0404.1996.tb07052.x.
We studied the concentration of hyaluronan in cerebrospinal fluid (CSF) in various diseases and attempted to define its reference interval. A radioassay utilizing cartilage proteins with affinity for hyaluronan was used in determining the concentration of 200 lumbar and 27 ventricular CSF specimens and 11 brain cyst fluids. Molecular weight distributions were determined by gel chromatography and localization in brain tissue by histochemistry. The hyaluronan level of lumbar CSF showed an increase with age; comparatively healthy children had (mean +/- SD) 50 +/- 41 micrograms/L (n = 40) and adults 166 +/- 77 micrograms/L (n = 9); i.e. significantly different values. The highest level was recorded in a patient with meningitis (> 8000 micrograms/L). More than 4000 micrograms/ L was noted in a patient with tumour metastasis in the cerebellum. Significantly elevated levels were especially found with spinal stenosis, head injury and cerebral infarction, but also in inflammatory medical disorders, hydrocephalus and encephalitis. We found no significant increase in multiple sclerosis and some other neurological diseases. Ventricular CSF of adults contained significantly less hyaluronan (53 +/- 73 micrograms/L; n = 16) than lumbar CSF. Hyaluronan in cyst fluids varied from 31 to 25,000 micrograms/L. Weight average molecular weight of hyaluronan in CSF was 2.9-3.0 x 10(5) and in brain tumour cyst fluid 2.4 x 10(6). In search for the origin of hyaluronan in CSF it was found that its concentration in the choroid plexus and leptomeninges was low, but that hyaluronan was accumulated in the superficial layer of the cerebral cortex. Continued screening for hyaluronan in CSF may be valuable in cases of inflammatory diseases, tumours and obstruction to CSF flow.
我们研究了各种疾病患者脑脊液（CSF）中透明质酸的浓度，并试图确定其参考区间。采用一种利用对透明质酸具有亲和力的软骨蛋白的放射测定法，对200份腰椎脑脊液标本、27份脑室脑脊液标本和11份脑囊肿液进行了浓度测定。通过凝胶色谱法测定分子量分布，并通过组织化学法确定其在脑组织中的定位。腰椎脑脊液中的透明质酸水平随年龄增长而升高；相对健康的儿童（平均值±标准差）为50±41μg/L（n = 40），成人则为166±77μg/L（n = 9）；即两者值有显著差异。脑膜炎患者的水平最高（> 8000μg/L）。一名小脑有肿瘤转移的患者中发现其水平超过4000μg/L。在脊髓狭窄、头部损伤和脑梗死患者中尤其发现水平显著升高，在炎症性疾病、脑积水和脑炎患者中也是如此。我们发现多发性硬化症和其他一些神经系统疾病中没有显著升高。成脑室脑脊液中的透明质酸含量（53±73μg/L；n = 16）明显低于腰椎脑脊液。囊肿液中的透明质酸含量在31至25000μg/L之间。脑脊液中透明质酸的重均分子量为2.9 - 3.0×10⁵，脑肿瘤囊肿液中为2.4×10⁶。在寻找脑脊液中透明质酸的来源时发现，其在脉络丛和软脑膜中的浓度较低，但在大脑皮质表层有积累。对于炎症性疾病、肿瘤和脑脊液流动受阻的病例，持续检测脑脊液中的透明质酸可能具有重要价值。
