title: Cerebrospinal fluid concentrations of pterins and metabolites of serotonin and dopamine in a pediatric reference population.
abstract: Accurate diagnosis and management of inborn errors of monoamine neurotransmitter and tetrahydrobiopterin metabolism depend on reliable reference ranges of key metabolites. Cerebrospinal fluid (CSF) was collected in a standardized way from 73 children and young adults with neurologic disease, with strict exclusions. In each specimen, concentrations of homovanillic acid (HVA), 5-hydroxyindoleacetic acid (HIAA), total neopterin, 7,8-dihydrobiopterin, and tetrahydrobiopterin (BH4) were measured using HPLC. There was a continuous decrement in CSF HVA, HIAA, and BH4 during the first few years of life; this was independent of height (or length). Age-related reference ranges for each metabolite are given. Extensive correlations between HVA, HIAA, 7,8-dihydrobiopterin, and BH4 were further analyzed by multiple regression. Age and CSF BH4 were significant explanatory variables for CSF HIAA, but CSF HVA had only HIAA as a significant explanatory variable.
authors.affiliation: Institute of Child Health, London, United Kingdom.
authors.forename: K
authors.initials: K
authors.lastname: Hyland
authors.forename: R A
authors.initials: RA
authors.lastname: Surtees
authors.forename: S J
authors.initials: SJ
authors.lastname: Heales
authors.forename: A
authors.initials: A
authors.lastname: Bowron
authors.forename: D W
authors.initials: DW
authors.lastname: Howells
authors.forename: I
authors.initials: I
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001708:Biopterins / Q000031:analogs & derivatives / Q000134:cerebrospinal fluid; D002648:Child; D002675:Child, Preschool; D004298:Dopamine / Q000378:metabolism*; D006719:Homovanillic Acid / Q000134:cerebrospinal fluid; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid; D007223:Infant; D019798:Neopterin; D011622:Pterins / Q000134:cerebrospinal fluid*; D012016:Reference Values; D012701:Serotonin / Q000378:metabolism*
chemical_list: D011622:Pterins; D001708:Biopterins; D012701:Serotonin; D006897:Hydroxyindoleacetic Acid; D019798:Neopterin; C017226:7,8-dihydrobiopterin; C003402:sapropterin; D004298:Dopamine; D006719:Homovanillic Acid