PLASMINOGEN-ACTIVATOR INHIBITOR-1 IN THE CEREBROSPINAL-FLUID AS AN INDEX OF NEUROLOGICAL DISEASE

Plasminogen activator inhibitor-1 (PAI-1) is a serpin proteinase inhib itor which regulates fibrinolysis and the proteinase cascade of tumour invasion. In this study, PAI-1 was identified in the cerebrospinal fl uid (CSF) from patients without neurological disease and patients with various neurological disorders. The mean level of PAI-1 in the CSF of 28 patients without central nervous system (CNS) disease was 0.28 +/- 0.03 (SEM) ng/ml. CSF PAI-1 was significantly increased in the follow ing diagnostic categories: dementia (Alzheimer's disease), cerebral in farction, CNS infection, alcohol withdrawal seizures and CNS neoplasia . In all these disorders, with the exception of CNS infection, PAI-1 w as also increased as a fraction of total CSF protein. CSF PAI-1 was no t increased in patients with hydrocephalus or idiopathic seizure disor ders. Complementary plasma samples were available for 18 of the 128 CS F specimens studied. For these cases, there was no correlation between plasma PAI-1 and CSF PAI-1 levels. PAI-I may represent a non-specific marker of disease in the central nervous system.