CEREBROSPINAL-FLUID AND SERUM NITRIC-OXIDE METABOLITES IN PATIENTS WITH MULTIPLE-SCLEROSIS

Nitric oxide is hypothesised to ploy a role in the immunopathogenesis of multiple sclerosis. Raised cerebrospinal fluid and serum levels of the nitric oxide metabolites nitrate and nitrite have been described i n patients with multiple sclerosis. Cerebrospinal fluid and serum nitr ate and nitrite were measured in patients with multiple sclerosis, inf lammatory and non-inflammatory neurological diseases, and correlated w ith the albumin quotient, an index of blood-brain-barrier dysfunction. Patients undergoing diagnostic lumber and vene puncture were prospect ively recruited, clinical data were obtained from the hospital records , and the CSF and serum nitrate and nitrite levels were measured by th e nitrate reductase and Griess reaction methods. Nitrate and nitrite, were raised in the CSF and serum of patients with multiple sclerosis a nd other inflammatory neurological diseases compared to patients with non-inflammatory neurological disorders (median nitrate and nitrite: c erebrospinal fluid=10.3 mu M vs 15.4 mu M vs 6.6 mu M, P<0.001, and se rum=49.0 mu M vs 46.4 mu M vs 38.8 mu M, P=0.02, respectively). CSF ni trate and nitrite levels correlated with the albumin quotient (n=59, r =0.42, P< 0.001). This study provides further evidence for a role of n itric oxide in the immunopathogenesis of multiple sclerosis and suppor ts a role for nitric oxide as a possible mediator of inflammatory bloo d-brain-barrier dysfunction.