Abstract

FACIO, María Laura et al. Apolipoproteína A-I en líquido cefalorraquídeo en pacientes con bandas oligoclonales. Acta bioquím. clín. latinoam. [online]. 2023, vol.57, n.1, pp.49-60. ISSN 0325-2957.

The presence of oligoclonal bands (OB) in cerebrospinal fluid (CSF) is of diagnostic importance in multiple sclerosis (MS). MS is an inflammatory, demyelinating and neurodegenerative disease of the central nervous system, of autoimmune origin that presents two evolutionary phases: inflammatory and neurodegenerative. MS treatment continues to transform with options for various therapies. The objective of this work was to find the protein profile in CSF, at the beginning of the disease, where the inflammatory reaction predominates, by two-dimensional electrophoresis for clinical use. To this aim, 37 paired samples (CSF and serum) with medical request for study of OB by isoelectric focusing were introduced. As CSF control, 5 samples from spontaneous nasal fistula of patients without neurological disease were used. Of the 37 patients with suspected MS, 54% presented OB, 65% of which presented apolipoprotein A-I (Apo A-I), with statistical significance (p=0.002, 87% sensitivity and 68% specificity, PPV 65% and NPV 88%). Apo A-I was accompanied by positive acute phase reactant proteins: haptoglobin in 100% and orosomucoid in 69% of cases. There was a diagnosis in 7 of the 37 patients: 1 spectrum of neuromyelitis optica and 6 MS with a “relapsing-remitting” course: 4 without active lesion by magnetic resonance imaging (MRI) and 2 with active lesion by MRI, with gadolinium. Haptoglobin and/or orosomucoid are seen when there are active lesions on MRI. Therefore, the presence of Apo A-I could represent an active demyelinating lesion in MS patients.

Keywords : Apolipoprotein A-I; Cerebrospinal fluid; Multiple sclerosis; Haptoglobin.

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