ANALYSIS OF GLIAL FIBRILLARY ACIDIC PROTEIN IN THE CEREBROSPINAL-FLUID OF CHILDREN INVESTIGATED FOR ENCEPHALOPATHY

The clinical application of a newly developed highly sensitive ELISA m ethod (20) to assay glial fibrillary acidic protein (GFAP) in the cere brospinal fluid (CSF) was investigated in children and adolescents wit h neurological disorders. GFAP analysis was explored as a tool to diff erentiate disorders with ongoing astrocytosis. A consecutive series of 34 subjects, 17 boys and 17 girls, with nonprogressive and progressiv e neurological encephalopathies was compared to 10 healthy controls. T he mean CSF GFAP concentration of the controls was 60.6 +/- 54 ng/l (S D). The group of 24 subjects (12 boys and 12 girls) with progressive n eurologic disorders had higher mean CSF GFAP levels than the group of 10 subjects (5 boys and 5 girls) with non-progressive disorders, 222.6 +/- 186 and 127.5 +/- 86 ng/l, respectively. The progressive encephal opathies differed significantly from controls (p < 0.01) while the non -progressive did not. The mean GFA-P concentration of the epilepsy cas es (n = 18) and non-epilepsy cases (n = 16) was 212.9 +/- 196 and 174. 0 +/- 132 ng/l, respectively. The epilepsy cases differed significantl y from controls which could be explained by the dominance of progressi ve cases (15 out of 18). Six subjects with known gliotic progressive d isorders (glutaric aciduria Type 1, Unverricht-Lundborg disease, Halle rvorden-Spatz disease, Jansky-Bielschowsky disease and juvenile Huntin gton disease) differed significantly, as expected, from controls with a mean CSF GFAP concentration of 326.2 +/- 132.5 ng/l, p < 0.001. The group with Lennox-Gastaut syndrome (3 boys and 3 girls) also differed significantly from controls (205.0 +/- 107.6, p < 0.01). The findings provide support for a correlation between clinically progressive neuro logical disorders in children and elevated CSF GFAP.