title: Analyses of haptoglobin level in the cerebrospinal fluid and serum of patients with neuromyelitis optica and multiple sclerosis.
abstract: BACKGROUND
  Neuromyelitis optica (NMO), which was previously considered a variant of multiple sclerosis (MS), is characterized by recurrent optic neuritis and longitudinally extensive spinal cord lesions. It has been shown that the level of haptoglobin in cerebrospinal fluid (CSF) is elevated in NMO. However, it is uncertain whether this change is specific to NMO, or is also seen in MS and other neurological diseases.
  
  
  METHODS
  We used an enzyme-linked immunosorbent assay (ELISA) to measure the haptoglobin levels in the CSF and serum in 25 NMO, 16 MS, and 15 Alzheimer's disease (AD) patients and 22 controls.
  
  
  RESULTS
  The CSF haptoglobin concentration of the NMO patients (0.309±0.074mg/dl, P<0.001) was significantly higher than that of MS patients (0.081±0.016mg/dl) and AD patients (0.058±0.011mg/dl), and the controls (0.060±0.009mg/dl), whereas the serum haptoglobin and albumin concentrations in the serum and CSF did not differ significantly across groups. NMO patients (0.59±0.15, P=0.001) demonstrated a higher haptoglobin index than MS patients (0.13±0.01), AD patients (0.12±0.03), and the controls (0.17±0.04). Furthermore, the haptoglobin concentration and haptoglobin index in the CSF correlated significantly with the expanded disability scale score (EDSS) in NMO patients.
  
  
  CONCLUSIONS
  The high CSF haptoglobin concentration in NMO may be explained by increased intrathecal haptoglobin synthesis. The correlation between CSF haptoglobin concentration/haptoglobin index and EDSS highlights the potential of haptoglobin as a biomarker of NMO.
authors.affiliation: Department of Neurology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan.
authors.forename: Kuo-Hsuan
authors.initials: KH
authors.lastname: Chang
authors.forename: Mu-Yun
authors.initials: MY
authors.lastname: Tseng
authors.forename: Long-Sun
authors.initials: LS
authors.lastname: Ro
authors.forename: Rong-Kuo
authors.initials: RK
authors.lastname: Lyu
authors.forename: Yu-Han
authors.initials: YH
authors.lastname: Tai
authors.forename: Hong-Shiu
authors.initials: HS
authors.lastname: Chang
authors.forename: Yih-Ru
authors.initials: YR
authors.lastname: Wu
authors.forename: Chin-Chang
authors.initials: CC
authors.lastname: Huang
authors.forename: Wen-Chuin
authors.initials: WC
authors.lastname: Hsu
authors.forename: Hung-Chou
authors.initials: HC
authors.lastname: Kuo
authors.forename: Chun-Che
authors.initials: CC
authors.lastname: Chu
authors.forename: Chiung-Mei
authors.initials: CM
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000544:Alzheimer Disease / Q000097:blood / Q000134:cerebrospinal fluid; D005260:Female; D006242:Haptoglobins / Q000032:analysis* / Q000134:cerebrospinal fluid*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000097:blood* / Q000134:cerebrospinal fluid*; D009471:Neuromyelitis Optica / Q000097:blood* / Q000134:cerebrospinal fluid*
chemical_list: D006242:Haptoglobins