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Detection of cerebrospinal fluid leakage by isoelectric focusing on polyacrylamide gels with silver staining using the PhastSystem. 1995

K Blennow, and P Fredman
Department of Clinical Neuroscience, University of Göteborg, Sweden.

Cerebrospinal fluid (CSF) leakage, which sometimes occurs after skull trauma, is a life-threatening condition. A prompt start with antibiotics and/or prompt surgical treatment of fistulas is essential to avoid severe complications. This requires a fast and reliable method for detecting CSF leakage. This paper describes a fast (< 2 h) method based on the identification of the tau protein (beta 2-transferrin) band(s). Tau protein is a brain-specific variant of transferrin that is characteristic of CSF. The method includes iso-electric focusing (IEF) on pre-cast polyacrylamide gels and silver staining using the PhastSystem, an automated instrument for electrophoresis and staining. In the present study, this technology was applied on 200 consecutive CSF samples, 32 of which were from healthy volunteers. Tau protein was detected in all CSF samples but 5 (2.5%), all of which were from patients with blood-brain barrier (BBB) damage. In these cases, the tau protein band was indistinct when direct silver staining was used. Therefore, immunofixation with an antitransferrin antibody was performed, and after that the tau protein band was easy to detect. The specificity of the method was high, since no brain-specific tau protein band was detected in serum, tears, saliva, or nasal secretion. As IEF of CSF using the PhastSystem is increasingly used as the routine method for detection of oligoclonal bands of IgG in neurological disorders, it could readily be used in the clinical (neuro) chemical laboratory also for the less frequent cases of suspected CSF leakage.

UI MeSH Term Description Entries
D007525 Isoelectric Focusing Electrophoresis in which a pH gradient is established in a gel medium and proteins migrate until they reach the site (or focus) at which the pH is equal to their isoelectric point. Electrofocusing,Focusing, Isoelectric
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D012016 Reference Values The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality. Normal Range,Normal Values,Reference Ranges,Normal Ranges,Normal Value,Range, Normal,Range, Reference,Ranges, Normal,Ranges, Reference,Reference Range,Reference Value,Value, Normal,Value, Reference,Values, Normal,Values, Reference
D001812 Blood-Brain Barrier Specialized non-fenestrated tightly-joined ENDOTHELIAL CELLS with TIGHT JUNCTIONS that form a transport barrier for certain substances between the cerebral capillaries and the BRAIN tissue. Brain-Blood Barrier,Hemato-Encephalic Barrier,Barrier, Blood-Brain,Barrier, Brain-Blood,Barrier, Hemato-Encephalic,Barriers, Blood-Brain,Barriers, Brain-Blood,Barriers, Hemato-Encephalic,Blood Brain Barrier,Blood-Brain Barriers,Brain Blood Barrier,Brain-Blood Barriers,Hemato Encephalic Barrier,Hemato-Encephalic Barriers
D002558 Cerebrospinal Fluid Otorrhea Discharge of cerebrospinal fluid through the external auditory meatus or through the eustachian tube into the nasopharynx. This is usually associated with CRANIOCEREBRAL TRAUMA (e.g., SKULL FRACTURE involving the TEMPORAL BONE;), NEUROSURGICAL PROCEDURES; or other conditions, but may rarely occur spontaneously. (From Am J Otol 1995 Nov;16(6):765-71) Cerebrospinal Otorrhea,Cerebrospinal Fluid Otorrhea, Post-Traumatic,Cerebrospinal Fluid Otorrhea, Spontaneous,Cerebrospinal Fluid Otorrhea, Traumatic,Otorrhea, Cerebrospinal Fluid, Post-Traumatic,Otorrhea, Cerebrospinal Fluid, Spontaneous,Otorrhea, Cerebrospinal Fluid, Traumatic,Otorrhea, Post-Traumatic, Cerebrospinal Fluid,Otorrhea, Spontaneous, Cerebrospinal Fluid,Otorrhea, Traumatic Cerebrospinal Fluid,Post-Traumatic Cerebrospinal Fluid Otorrhea,Post-Traumatic Otorrhea, Cerebrospinal Fluid,Spontaneous Cerebrospinal Fluid Otorrhea,Spontaneous Otorrhea, Cerebrospinal Fluid,Traumatic Cerebrospinal Fluid Otorrhea,Traumatic Otorrhea, Cerebrospinal Fluid,Cerebrospinal Fluid Otorrhea, Post Traumatic,Cerebrospinal Fluid Otorrheas,Otorrhea, Cerebrospinal,Otorrhea, Cerebrospinal Fluid,Post Traumatic Cerebrospinal Fluid Otorrhea,Post Traumatic Otorrhea, Cerebrospinal Fluid
D002559 Cerebrospinal Fluid Rhinorrhea Discharge of cerebrospinal fluid through the nose. Common etiologies include trauma, neoplasms, and prior surgery, although the condition may occur spontaneously. (Otolaryngol Head Neck Surg 1997 Apr;116(4):442-9) Cerebrospinal Rhinorrhea,CSF Rhinorrhea,Cerebrospinal Fluid Rhinorrhea, Post-Traumatic,Cerebrospinal Fluid Rhinorrhea, Spontaneous,Cerebrospinal Fluid Rhinorrhea, Traumatic,Post-Traumatic Cerebrospinal Fluid Rhinorrhea,Post-Traumatic Rhinorrhea, Cerebrospinal Fluid,Rhinorrhea, Cerebrospinal Fluid, Post-Traumatic,Rhinorrhea, Cerebrospinal Fluid, Spontaneous,Rhinorrhea, Cerebrospinal Fluid, Traumatic,Rhinorrhea, Post-Traumatic, Cerebrospinal Fluid,Rhinorrhea, Spontaneous Cerebrospinal Fluid,Rhinorrhea, Traumatic Cerebrospinal Fluid,Spontaneous Cerebrospinal Fluid Rhinorrhea,Spontaneous Rhinorrhea, Cerebrospinal Fluid,Traumatic Cerebrospinal Fluid Rhinorrhea,Traumatic Rhinorrhea, Cerebrospinal Fluid,CSF Rhinorrheas,Cerebrospinal Fluid Rhinorrhea, Post Traumatic,Cerebrospinal Fluid Rhinorrheas,Cerebrospinal Rhinorrheas,Post Traumatic Cerebrospinal Fluid Rhinorrhea,Post Traumatic Rhinorrhea, Cerebrospinal Fluid,Rhinorrhea, CSF,Rhinorrhea, Cerebrospinal,Rhinorrhea, Cerebrospinal Fluid,Rhinorrheas, CSF,Rhinorrheas, Cerebrospinal,Rhinorrheas, Cerebrospinal Fluid
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D004591 Electrophoresis, Polyacrylamide Gel Electrophoresis in which a polyacrylamide gel is used as the diffusion medium. Polyacrylamide Gel Electrophoresis,SDS-PAGE,Sodium Dodecyl Sulfate-PAGE,Gel Electrophoresis, Polyacrylamide,SDS PAGE,Sodium Dodecyl Sulfate PAGE,Sodium Dodecyl Sulfate-PAGEs

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