Apolipoprotein E in cerebrospinal fluid: Relation to phenotype and plasma apolipoprotein E concentrations

Background: Apolipoprotein (apo) E may be related to the development of Alz heimer disease, but data on apoE in cerebrospinal fluid (CSF) are limited. The aim of the present study was to measure apoE in CSF and relate its conc entrations to apoE phenotype and CSF lipids. Methods: We adapted an assay for CSF apoE sensitivity using an ELISA. It al lowed us to measure CSF apoE with sufficient reproducibility and precision. Results: The within- and between-run CVs were <7%, and the detection limit was 0.025 mg/L. No cross-reaction was found for other apolipoproteins. No s ignificant differences related to sex or apoE phenotype were observed in th e CSF apoE concentration. The mean CSF apoE concentration was significantly higher in the 0-5 year group (n = 6; 18.47 +/- 1.14 mg/L, mean +/- SD) tha n in the >5 year group (n = 34; 8.82 +/- 3.31 mg/L). The mean concentration s of total cholesterol (TC) and phospholipid (PL) in CSF were 2.68 +/- 2.16 and 6.50 +/- 2.84 mg/L (n = 52), respectively. Although no significant dif ferences in TC or PL in the CSF were found with respect to sex or age, the concentrations in subjects with the apoE phenotype E4/E3 were significantly lower than in those with E3/E3 and E3/E2. The concentrations of apoE, TC, and PL in CSF did not correlate with those in plasma. The time-related fluc tuations in CSF apoE were independent of those in total protein and IgG. CS F apoE was significantly correlated with TC and PL concentrations in the CS F, but not with the number of: cells in the CSF. Conclusions: These findings support the idea that apoE and lipids are unabl e to cross the blood-brain barrier and that their concentrations in CSF may reflect production in central nervous tissue. (C) 1999 American Associatio n for Clinical Chemistry.