title: Decreased allopregnanolone levels in cerebrospinal fluid obtained during status epilepticus.
abstract: Neuroactive steroids are increasingly considered as relevant modulators of neuronal activity. Especially allopregnanolone (AP) and pregnenolone sulfate (PS) have been shown to possess, respectively, anticonvulsant or proconvulsant properties. In view of the potential role of these steroids, we aimed at evaluating AP and PS levels in cerebrospinal fluid (CSF) and blood samples obtained from patients with status epilepticus (SE). To this purpose, we enrolled 41 patients affected by SE and 41 subjects investigated for nonepileptic neurologic disorders. Liquid chromatographic procedures coupled with electrospray tandem mass spectrometry and routine laboratory investigations were performed. Significantly lower AP levels were found in the CSF of patients affected by SE (-30%; p < 0.05, Mann-Whitney test). Notably, AP was not detectable in 28 of 41 patients affected by SE (p < 0.01 vs. controls, Fisher's exact test). In serum, AP levels did not differ in the two considered groups. Conversely, PS was present at similar levels in the investigated groups. Finally, differences in AP levels could not be explained by a variation in CSF albumin content. These findings indicate that AP is defective in the CSF of patients affected by SE. This phenomenon was not dependent on carriers for steroids, such as albumin.
authors.affiliation: Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.|Department of Neurosciences, NOCSAE Hospital, AUSL Modena, Modena, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Meletti
authors.affiliation: Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.|Department of Neurosciences, NOCSAE Hospital, AUSL Modena, Modena, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Lucchi
authors.affiliation: Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Monti
authors.affiliation: Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Giada
authors.initials: G
authors.lastname: Giovannini
authors.affiliation: Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.|Department of Neurosciences, NOCSAE Hospital, AUSL Modena, Modena, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Bedin
authors.affiliation: Department of Laboratory Medicine and Pathological Anatomy, NOCSAE Hospital, AUSL Modena, Modena, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Trenti
authors.affiliation: Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Rustichelli
authors.affiliation: Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.|Department of Neurosciences, NOCSAE Hospital, AUSL Modena, Modena, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Biagini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002851:Chromatography, High Pressure Liquid; D002853:Chromatography, Liquid; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged; D011280:Pregnanolone / Q000097:blood / Q000134:cerebrospinal fluid*; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000097:blood / Q000134:cerebrospinal fluid*; D055815:Young Adult
chemical_list: D011280:Pregnanolone
keywords: Allopregnanolone; Cerebrospinal fluid; LC-MS/MS; Pregnenolone sulfate; Status epilepticus