Alpha 1-antitrypsin in cerebrospinal fluid of patients with neurologic diseases
G. S. Pearl and R. E. Mullins
Proteases and their inhibitors have been implicated in the pathogenesis of
neuroimmunologic diseases, particularly multiple sclerosis (MS). We
measured the immunochemical level and functional activity of alpha
1-antitrypsin (AAT) in cerebrospinal fluid (CSF) and serum in patients with
MS and other neurologic diseases. Increases in the immunochemical level of
AAT in CSF correlated directly with disturbances in the blood-brain
barrier, as reflected by the ratio of albumin in CSF to that in serum. The
AAT activity in CSF directly correlated with the immunochemical level when
all patients were compared. However, the AAT activity in patients with
inflammatory diseases tended to be decreased relative to the immunochemical
level, suggesting inactivation of AAT in these disorders. The AAT activity
was not significantly altered in patients with MS, despite reports of
increased protease activity in active MS.
