Alteration of cystatin C in cerebrospinal fluid of patients with sciatica revealed by a proteomical approach

To better understand the pathophysiological mechanisms underlying sciatica induced by lumbar intervertebral disk herniation and to ascertain the protein that presents with the most observable changes in the cerebrospinal fluid [CSF] of patients with sciatica. We conducted the study in the Key Laboratory of Shanghai 6th People's Hospital, Shanghai Jiaotong University, Shanghai, Peoples Republic of China, during the period June 2004 to March 2005. In 2 separate experiments, we carried out the study involving the CSF of sciatica patients [the case group] and the CSF of otherwise, healthy volunteers [the control group]. We utilized a proteomical analysis to compare the samples of 10 patients with sciatica with 10 volunteers in the control group. We individually separated each of the groups' CSF by 2-dimensional gel electrophoresis. We analyzed the harvested gel images with PD Quest 2D-gel software [Bio-Rad] to ascertain the differential proteins between the 2 groups. We based the enzyme linked immuno- absorbent assay [ELISA] experiment, which followed, on the results of the first experiment. We found 15 of the protein spots in the CSF differed appreciably in varying degrees between the 2 groups, and identification made by LC-MS/MS revealed that the most significant disparity was with cystatin C. The result of ELISA experiment confirmed a considerable decrease in the level of cystatin C [p<0.01] in the patients with sciatica. In the CSF of patients with sciatica, the volume of cystatin C increased markedly indicating that it may play an important role in the pathophysiological processes of sciatica

Interferon-gamma inducing factor [IL-18], interferon-gamma and cystatin C levels of children with meningitis

The objective of this study was to measure the levels of interleukin [IL]-18, interferon [IFN]- gamma and cystatin C in the cerebrospinal fluid [CSF] of children with meningitis. The study was carried out on 30 patients [12 males and 18 females] admitted to in-patient pediatric department in El Minya fever hospital and EL-Minya University hospital, for evaluation and treatment from meningitis during the period from January 2004 to December 2004. Within the entire group of the study the most common signs of meningitis were included. Thirteen children had septic meningitis [positive CSF culture] and 17 children had aseptic meningitis [negative CSF culture and lymphomonocytic pleocytosis in CSF analysis]. Twenty children of matched age and sex, having normal CSF during evaluation for meningitis, served as a control group. All CSF samples were obtained under aseptic conditions. CSF samples were cultured, analyzed for glucose, protein and WBCs. Another part from CSF samples assayed were immediately frozen at-70°C unit cystatin C, IFN-gamma and IL-18 in CSF were assaved by using a two -site enzyme linked immunosorbent assayed for cystatin C, IL-18 and IFN-gamma. The results showed that septic meningitis group had significantly higher CSF WBCs and protein levels than in aseptic meningitis and control groups [P<0.005]. IL-18 was significantly higher in septic group, it was detected in 95% of children with septic meningitis and only in the CSF of 48% of aseptic meningitis group. In control subjects, 10% had detectable levels of IL-18 in the CSF. IFN-gamma was significantly higher in aseptic group, it was detected in 96% of aseptic meningitis and 35% of children with septic meningitis, while 21% was detected in CSF of control subjects. cystatin C was detected in 44% of children with septic and aseptic meningitis, compared with control children [P<0.001], While cystatin C was significantly decreased in septic and aseptic groups. No significant correlation was found between IL-18,IFN-Y and cystatin C levels and total leukocyte count in the CSF of children with meningitis. Our data suggest that IL18, IFN-gamma and cystatin C are significantly changed in the CSF of children with meningitis. IL18 had greatest elevations while cystatin C was significantly decreased in those children with septic meningitis. IFN-gamma had greatest elevation seen in those children with aseptic meningitis. So, cystatin C and IL18 could be considered as sensitive and specific parameters for detection of septic meningitis, while IFN-gamma could be considered as sensitive and specific parameter for detection of aseptic meningitis