GLIAL FIBRILLARY ACIDIC PROTEIN IN THE CEREBROSPINAL-FLUID - A POSSIBLE INDICATOR OF PROGNOSIS IN FULL-TERM ASPHYXIATED NEWBORN-INFANTS

Glial fibrillary acidic protein (GFAP) is the structural protein of in termediate filaments in astroglia. GFAP has extensively been used as a marker of gliosis in neuropathology. It also appears in excessive amo unts in the cerebrospinal fluid in various acute brain disorders. Hypo xic-ischemic encephalopathy after perinatal asphyxia is a condition in which levels of GFAP could be expected to be elevated if brain cell d amage occurs. We examined levels of GFAP by a sensitive ELISA in the c erebrospinal fluid of full-term infants between 12 and 48 h after birt h. Cerebrospinal fluid-GFAP increased 5-fold in infants after perinata l asphyxia compared with a reference group (675 versus 137 ng/L, p < 0 .001). The levels of GFAP also increased gradually in accordance with the severity of the neurologic symptoms ranked as degree of hypoxic-is chemic encephalopathy. We conclude that the cerebrospinal fluid levels of GFAP might be an important adjunct in the neonatal assessment of i nfants subject to perinatal asphyxia, and together with other neuronal or glial proteins, it might also help in defining temporal relationsh ips asphyxia.