Abstract
For diagnosis, determining the severity and prognosis of central nervous system (CNS) disorders, measurement of various parameters in the cerebrospinal fluid (CSF) is more clinically useful than the measurement of serum parameters. We measured the levels of four substances [neuron-specific enolase (NSE), 2', 5' -oligoadenyl acid synthetase (2-5AS) activity, neopterin and matrix metalloproteinase 9 (MMP-9)] in CSF as unique parameters of CNS disorders.
1) NSE levels were significantly higher in neonates with severe bran damage and in children with bacterial meningitis than in controls. NSE levels remained high in those with poor neurological prognosis. These findings suggested that NSE could be a marker of neuronal damage. 2) 2-5 AS activity was markedly increased in children with viral infection of CNS (aseptic meningitis). This marker was useful for establishing an early diagnose and for predicting whether the illness would be prolonged. 3) Neopterin levels were significantly elevated in children with bacterial and aseptic meningitis, so it was considered useful for evaluating inflammation of the CNS. 4) MMP-9 levels were abnormally increased in children with bacterial meningitis, but were low in children with other inflammatory diseases of the CNS. These findings indicated that MMP-9 would be a useful marker for establishing a definite diagnosis of bacterial meningitis and for assessing clinical prognosis.
