Amino acid cerebrospinal fluid/plasma ratios in children: influence of age, gender, and antiepileptic medication.
OBJECTIVE
The purpose of this work was to investigate the influence of age, gender, and antiepileptic therapy on amino acid cerebrospinal fluid/plasma ratios in children.


METHODS
Concentrations of 17 amino acids measured by ion-exchange chromatography with ninhydrin detection in plasma and cerebrospinal fluid from 68 patients with neurologic diseases were used to calculate their cerebrospinal fluid/plasma ratios (70 measurements; 28 female patients [29 punctures] and 40 male patients [41 punctures]). Age dependence and the effects of gender and antiepileptic medication on amino acid cerebrospinal fluid/plasma ratios were investigated by linear multiple regression analysis, and nonstandardized predicted mean values for 2 age groups were calculated (cutoff: 3 years old).


RESULTS
The cerebrospinal fluid/plasma ratios ranged between 0.02 for glycine and 0.93 for glutamine. Age had a significant influence on cerebrospinal fluid/plasma ratios for valine, isoleucine, leucine, and tyrosine, with higher ratios in younger children. Gender had a significant influence only on the glutamine cerebrospinal fluid/plasma ratio (female patients had lower ratios). Cerebrospinal fluid/plasma ratios of glutamine and tyrosine were significantly elevated by valproate therapy and those of serine, asparagine, glutamine, valine, methionine, and phenylalanine by phenobarbital therapy. No significant influence of age, gender, and antiepileptic drugs was detectable on cerebrospinal fluid/plasma ratios of threonine, proline, glycine, alanine, histidine, ornithine, lysine, and arginine.


CONCLUSIONS
Cerebrospinal fluid/plasma ratios, especially for essential neutral amino acids and for serine, asparagine, and glutamine were influenced to different degrees by age, gender, and antiepileptic therapy.
Scholl-Bürgi
Sabine
S
Division of Neonatology, Neuropediatrics, and Inborn Errors of Metabolism, Innsbruck Medical University, Innsbruck, Austria. sabine.scholl-buergi@uki.at
Haberlandt
Edda
E
Heinz-Erian
Peter
P
Deisenhammer
Florian
F
Albrecht
Ursula
U
Sigl
Sara Baumgartner
SB
Rauchenzauner
Markus
M
Ulmer
Hanno
H
Karall
Daniela
D
D000293:Adolescent; D000367:Age Factors; D000596:Amino Acids / Q000097:blood* / Q000134:cerebrospinal fluid*; D000927:Anticonvulsants / Q000008:administration & dosage / Q000493:pharmacokinetics*; D015415:Biomarkers / Q000032:analysis; D001812:Blood-Brain Barrier / Q000187:drug effects / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004827:Epilepsy / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000175:diagnosis / Q000188:drug therapy; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis / Q000188:drug therapy; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012737:Sex Factors
D000596:Amino Acids; D000927:Anticonvulsants; D015415:Biomarkers