Remodelling of cerebrospinal fluid lipoproteins after subarachnoid hemorrhage

• Published in: Atherosclerosis Vol. 170; no. 1; pp. 141 - 146
• Main Authors: Kay, A.D., Day, S.P., Nicoll, J.A.R., Packard, C.J., Caslake, M.J.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01-09-2003; Elsevier
• Subjects: Adult; Aged; Aneurysm, Ruptured - cerebrospinal fluid; Apolipoprotein A-I - cerebrospinal fluid; Apolipoproteins E - cerebrospinal fluid; Area Under Curve; Biological and medical sciences; Brain injury; Cerebrospinal fluid; Cerebrospinal Fluid Proteins - analysis; Humans; Lipoproteins; Lipoproteins - blood; Lipoproteins - cerebrospinal fluid; Lipoproteins, HDL - cerebrospinal fluid; Lipoproteins, LDL - cerebrospinal fluid; Lipoproteins, VLDL - cerebrospinal fluid; Medical sciences; Middle Aged; Neurology; Particle Size; Phospholipids - cerebrospinal fluid; Statistics as Topic; Subarachnoid hemorrhage; Subarachnoid Hemorrhage - cerebrospinal fluid; United Kingdom; Vascular diseases and vascular malformations of the nervous system; Lipoproteins; Cerebrospinal fluid; Subarachnoid hemorrhage; Brain injury; Cerebrospinal fluid disease; Human; Nervous system diseases; Prognosis; Cardiovascular disease; Lipoprotein; Remodeling; Cerebral disorder; Vascular disease; Cerebral hemorrhage; Central nervous system disease; Subarachnoid; Cerebrovascular disease
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/S0021-9150(03)00249-1

Lipoprotein particles (Lps) in normal human cerebrospinal fluid (CSF) are distinct from those found in plasma and include unique apolipoprotein E (apoE indicates protein;
APOE, gene) containing lipoproteins rarely seen in human plasma. Less favourable neurological recovery after subarachnoid hemorrhage (SAH) has been observed in patients who posses the
APOE ε4 allele raising the possibility that apoE influences neuronal survival after brain injury. We analysed Lps from control and SAH CSF testing the hypotheses that following brain injury CSF Lps undergo remodelling and apoE containing Lps are selectively depleted from brain injury CSF. Lipoproteins were fractionated using CSF from six control pools and six patients with SAH on a sepharose 6HR 10/30 size exclusion column. Fractions were assayed for total cholesterol (TC), free cholesterol (FC), phospholipid, triglyceride (TG), apoE, apolipoprotein B (apoB), and apolipoprotein AI (apoAI). Compared to control CSF there were significant (
P<0.05) increases in TC, FC, TG, and apoAI in SAH CSF. Plasma sized apoB-containing lipoproteins and a very small apoAI-containing Lps were identified in the SAH CSF, which were not present in controls. However, despite the release of plasma lipoproteins into the subarachnoid space, there was no significant increase in CSF apoE. These data provide novel indirect evidence suggesting that after SAH CSF Lps undergo remodelling and apoE containing Lps are selectively reduced in brain injury CSF. The remodelling of CSF Lps and selective reduction of apoE containing lipoproteins may reflect an important response of the human brain to injury.