CEREBROSPINAL-FLUID ACTIVITY OF TISSUE-PLASMINOGEN ACTIVATOR IN PATIENTS WITH NEUROLOGICAL DISEASES

Aim-To study cerebrospinal fluid (CSF) activity of tissue plasminogen activator (tPA) in patients with neurological diseases. Methods-CSF tP A and urokinase (uPA) activities were studied using an immunocapture a ssay and zymography in 44 patients with neurological disease and 20 re ference subjects. The patient group comprised three patients with meni ngitis, 21 with encephalitis, nine with acute lymphoblastic (n = 7) an d myeloid (n = 2) leukaemia, seven with multiple sclerosis, three with facial paresis, and one with polyradiculitis. Results-Raised tPA acti vities were observed in patients with multiple sclerosis, leukaemia an d encephalitis. In contrast, there were no differences in the mean act ivities of tPA in patients with meningitis or other diseases compared with the reference subjects. The highest tPA activities were found in patients with multiple sclerosis. The mean activity in patients with l eukaemia was higher than in those with meningitis and polyradiculitis, but not encephalitis and facial paresis. Although the CSF tPA activit y correlated positively with age in reference subjects, no correlation was observed in patients. Samples were qualitatively screened for bot h tPA and uPA activity by zymography and positive samples were quantit ated. Some of the samples had quantifiable levels of uPA activity: thr ee of seven multiple sclerosis samples, 10 of 21 samples from patients with encephalitis and five of nine leukaemic samples. The highest act ivities were recorded in patients with leukaemia. uPA was not detected in the CSF of the patients with meningitis, facial paresis or polyrad iculitis. Conclusions-Plasminogen activator activity can be measured r eliably in CSF and the assessment of tPA activity may be useful for st udying the pathogenesis of neurological diseases.