The Value of Using ELISA to Detect Orexin-A in Cerebrospinal Fluid in the Diagnosis of Narcolepsy

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2024 Jun 14

PMID 38875396

Authors

Qingqing Zhan

Liying Deng

Yongmin Ding

Fen Wang

Fang Han

Bing Zhou

Liang Xie

Affiliations

Soon will be listed here.

Abstract

Orexin in cerebrospinal fluid (CSF) is a neuropeptide synthesized by a cluster of neurons in the lateral hypothalamus. It mainly functions to maintain arousal, regulate feeding, and participate in reward mechanisms. Radioimmunoassay (RIA) and enzyme-linked immunosorbent assay (ELISA) can detect CSF orexin. At present, RIA is widely used but is limited by various conditions, which is not conducive to its widespread development. We aimed to determine whether ELISA can replace RIA in detecting orexin in CSF. We investigated the results of 20 patients with central disorders of hypersomnolence, including 11 with narcolepsy type 1, 2 with narcolepsy type 2, 5 with idiopathic hypersomnia, and 2 with other causes of somnolence. RIA and ELISA were used to detect CSF orexin, and P values <.05 were considered to be significant. In the narcolepsy and non-narcolepsy type 1 groups, there was no correlation between the RIA and ELISA results (P > .05). In the narcolepsy type 1 group, the ELISA and RIA results were significantly different (P < .05), but this was not observed in the non-narcolepsy type 1 group (P > .05). The accuracy of ELISA to detect CSF orexin was lower than that of RIA (P < .05). ELISA cannot replace RIA in the measurement of CSF orexin, and RIA is recommended as the first choice when narcolepsy is suspected.

References

Torstensen E, Haubjerg Osterby N, Pizza F, Plazzi G, Antelmi E, Moresco M . Repeated measures of hypocretin-1 in Danish and Italian patients with narcolepsy and in controls. Sleep Med. 2022; 101:213-220. DOI: 10.1016/j.sleep.2022.10.004. View

Erickson J, Grenache D . A chromogranin A ELISA absent of an apparent high-dose hook effect observed in other chromogranin A ELISAs. Clin Chim Acta. 2015; 452:120-3. DOI: 10.1016/j.cca.2015.11.007. View

Liguori C, Placidi F, Izzi F, Nuccetelli M, Bernardini S, Sarpa M . Beta-amyloid and phosphorylated tau metabolism changes in narcolepsy over time. Sleep Breath. 2016; 20(1):277-83. DOI: 10.1007/s11325-015-1305-9. View

Thannickal T, Moore R, Nienhuis R, Ramanathan L, Gulyani S, Aldrich M . Reduced number of hypocretin neurons in human narcolepsy. Neuron. 2000; 27(3):469-74. PMC: 8760623. DOI: 10.1016/s0896-6273(00)00058-1. View

Liguori C, Moresco M, Izzi F, Mercuri N, Plazzi G, Placidi F . New revolution in the assessment of cerebrospinal fluid orexin-A: Enzyme-linked immunosorbent assay!. Psychiatry Clin Neurosci. 2018; 73(4):194-195. DOI: 10.1111/pcn.12816. View

Mignot E, Lammers G, Ripley B, Okun M, Nevsimalova S, Overeem S . The role of cerebrospinal fluid hypocretin measurement in the diagnosis of narcolepsy and other hypersomnias. Arch Neurol. 2002; 59(10):1553-62. DOI: 10.1001/archneur.59.10.1553. View

de Lecea L, Kilduff T, Peyron C, Gao X, Foye P, Danielson P . The hypocretins: hypothalamus-specific peptides with neuroexcitatory activity. Proc Natl Acad Sci U S A. 1998; 95(1):322-7. PMC: 18213. DOI: 10.1073/pnas.95.1.322. View

Kim J, Lee S, Lee S . Development of novel lab-on-a-chip platform for high-throughput radioimmunoassay. Appl Radiat Isot. 2020; 168:109526. DOI: 10.1016/j.apradiso.2020.109526. View

Liguori C, Placidi F, Albanese M, Nuccetelli M, Izzi F, Marciani M . CSF beta-amyloid levels are altered in narcolepsy: a link with the inflammatory hypothesis?. J Sleep Res. 2014; 23(4):420-4. DOI: 10.1111/jsr.12130. View

10.

Sailer C, Refardt J, Blum C, Schnyder I, Molina-Tijeras J, Fenske W . Validity of different copeptin assays in the differential diagnosis of the polyuria-polydipsia syndrome. Sci Rep. 2021; 11(1):10104. PMC: 8114908. DOI: 10.1038/s41598-021-89505-9. View

11.

You M, Peng P, Xue Z, Tong H, He W, Mao P . A fast and ultrasensitive ELISA based on rolling circle amplification. Analyst. 2021; 146(9):2871-2877. DOI: 10.1039/d1an00355k. View

12.

Sarkanen T, Sved G, Juujarvi M, Alakuijala A, Partinen M . Misdiagnosis of narcolepsy caused by a false-positive orexin-A/hypocretin-1 enzyme immune assay. J Clin Sleep Med. 2022; 18(8):2075-2078. PMC: 9340599. DOI: 10.5664/jcsm.10014. View

13.

Murata T, Tsuzaki K, Nirengi S, Watanabe T, Mizutani Y, Okada H . Diagnostic accuracy of the anti-glutamic acid decarboxylase antibody in type 1 diabetes mellitus: Comparison between radioimmunoassay and enzyme-linked immunosorbent assay. J Diabetes Investig. 2016; 8(4):475-479. PMC: 5497031. DOI: 10.1111/jdi.12594. View

14.

Carlson M, Snead W, Oeser A, Butler M . Plasma leptin concentrations in lean and obese human subjects and Prader-Willi syndrome: comparison of RIA and ELISA methods. J Lab Clin Med. 1999; 133(1):75-80. PMC: 6777556. DOI: 10.1053/lc.1999.v133.a94437. View

15.

Bourgin P, Zeitzer J, Mignot E . CSF hypocretin-1 assessment in sleep and neurological disorders. Lancet Neurol. 2008; 7(7):649-62. DOI: 10.1016/S1474-4422(08)70140-6. View

16.

Bekhbat M, Glasper E, Rowson S, Kelly S, Neigh G . Measuring corticosterone concentrations over a physiological dynamic range in female rats. Physiol Behav. 2018; 194:73-76. PMC: 6492035. DOI: 10.1016/j.physbeh.2018.04.033. View

17.

Sakurai T, Amemiya A, Ishii M, Matsuzaki I, Chemelli R, Tanaka H . Orexins and orexin receptors: a family of hypothalamic neuropeptides and G protein-coupled receptors that regulate feeding behavior. Cell. 1998; 92(4):573-85. DOI: 10.1016/s0092-8674(00)80949-6. View

18.

Dalal J, Roh J, Maloney S, Akuffo A, Shah S, Yuan H . Translational profiling of hypocretin neurons identifies candidate molecules for sleep regulation. Genes Dev. 2013; 27(5):565-78. PMC: 3605469. DOI: 10.1101/gad.207654.112. View

19.

Ono T, Kanbayashi T, Yoshizawa K, Nishino S, Shimizu T . Measurement of cerebrospinal fluid orexin-A (hypocretin-1) by enzyme-linked immunosorbent assay: A comparison with radioimmunoassay. Psychiatry Clin Neurosci. 2018; 72(11):849-850. DOI: 10.1111/pcn.12780. View