Multiple sclerosis: high resolution magnetic resonance spectroscopy and correlation with inflammatory course / Esclerose multipla : espectroscopia de protons de resolução do liquor e correlação com atividade inflamatoria

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

We studied cerebrospinal fluid (CSF) of 24 patients with multiple sclerosis (MS) and 11 control subjects by high resolution proton MR spectroscopy. The application of 1 H magnetic resonance spectroscopy in cerebrospinal fluid (CSF) analysis may detect metabolites in normal and pathological conditions. The purpose of this work was to evaluate what biochemical changes were related to multiple sclerosis (MS) and establish whether the CSF composition in MS patients reflects metabolic changes occurring in this demyelinating disease. CSF samples obtained by lumbar puncture in 24 MS patients (clinically definite), 9 male and 16 female, with mean age of disease beginning around 30 years, patients with idiopathic polyneuropathy ; headache, and meningitis, and one patient submitted to myelo-tomography were used as controls (11 patients). A portion of each CSF sample was stored until NMR analysis, at which time 0,5 ml CSF were added to 0,1 ml of 0,75 mM sodim 3-trimethyl-silylpropionate-2,2,3,3-d (TSP), chemical shift reference (0,0 ppm), in D20. A Varian INOVA-500 (11,7 T) spectrometer, operating at 499,886 MHz, was used. Spectra were recorded at 298 K and represented the sum of 64 transients acquired over 64 K data points with a spectral width of 10 kHz, All spectra were treated prior to the multivariate statistics and pattern recognition by adjusting the TPS peak to the same height and by correcting the spectra shift and baseline. Metabolite concentrations in CSF from the patients with MS and controls were determined by integration of isolated peaks measured relative to TSP, correcting for the relative number of protons. The major differences between the MS and control patients by visual inspection were the relative increased levels of acetoacetate; glutamine/glutamate and beta-hydroxybutirate in MS patients, compared to controls. Alanine, threonine, valine, leucine and isoleucine account for 40% of the myelin proteolipid protein and for 20% of the myelin basic protein. Acetoacetate and beta-hydroxybutirate result from the degradation of these aminoacids, which besides being related to the breakdown of myelin, may result of oligodendrocyte pathology. During inflammation, lymphocytes, microglia and macrophages release excessive amounts of glutamate. Astrocytes impairment of glutamate uptake may contribute to excitotoxic damage of oligodendrocytes in MS

ASSUNTO(S)

glutamine quimioterapia chemotherapy gadolinio acetoacetatos gadolinium glutamatos glutamates magnetic ressonance ressonancia magnetica

ACESSO AO ARTIGO

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