The Cerebral Surfactant System and Its Alteration in Hydrocephalic Conditions

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2016 Sep 23

PMID 27656877

Citations 11

Authors

Stefan Schob

Donald Lobsien

Benjamin Friedrich

Matthias K Bernhard

Corinna Gebauer

Julia Dieckow

Matthias Gawlitza

Mandy Pirlich

Dorothee Saur

Lars Brauer

Ingo Bechmann

Karl-Titus Hoffmann

Cynthia V Mahr

Ulf Nestler

Matthias Preuss

Affiliations

Soon will be listed here.

Abstract

Introduction: Pulmonary Surfactant reduces surface tension in the terminal airways thus facilitating breathing and contributes to host's innate immunity. Surfactant Proteins (SP) A, B, C and D were recently identified as inherent proteins of the CNS. Aim of the study was to investigate cerebrospinal fluid (CSF) SP levels in hydrocephalus patients compared to normal subjects.

Patients And Methods: CSF SP A-D levels were quantified using commercially available ELISA kits in 126 patients (0-84 years, mean 39 years). 60 patients without CNS pathologies served as a control group. Hydrocephalus patients were separated in aqueductal stenosis (AQS, n = 24), acute hydrocephalus without aqueductal stenosis (acute HC w/o AQS, n = 16) and idiopathic normal pressure hydrocephalus (NPH, n = 20). Furthermore, six patients with pseudotumor cerebri were investigated.

Results: SP A-D are present under physiological conditions in human CSF. SP-A is elevated in diseases accompanied by ventricular enlargement (AQS, acute HC w/o AQS) in a significant manner (0.67, 1.21 vs 0.38 ng/ml in control, p<0.001). SP-C is also elevated in hydrocephalic conditions (AQS, acute HC w/o AQS; 0.87, 1.71 vs. 0.48 ng/ml in controls, p<0.001) and in Pseudotumor cerebri (1.26 vs. 0.48 ng/ml in controls, p<0.01). SP-B and SP-D did not show significant alterations.

Conclusion: The present study confirms the presence of SPs in human CSF. There are significant changes of SP-A and SP-C levels in diseases affecting brain water circulation and elevation of intracranial pressure. Cause of the alterations, underlying regulatory mechanisms, as well as diagnostic and therapeutic consequences of cerebral SP's requires further thorough investigations.

Citing Articles

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Surfactant protein a attenuates generalized and localized neuroinflammation in neonatal mice.

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CSF Surfactant Protein Changes in Preterm Infants After Intraventricular Hemorrhage.

Krause M, Hartig W, Mahr C, Richter C, Schob J, Puchta J Front Pediatr. 2020; 8:572851.

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