Increased intrathecal production of apolipoprotein D in multiple sclerosis

Apolipoprotein D (apoD) is a small glycoprotein responsible for the local t ransport of small hydrophobic ligands. Within the nervous system, apoD may be an acute phase protein that is upregulated in a variety of neuropatholog ical conditions and is involved in the removal of lipids during nerve cell degeneration and provision of lipids during the regenerative phase. In this study, we measured cerebrospinal fluid (CSF) and serum apoD levels in patients with multiple sclerosis (MS), chronic inflammatory demyelinatin g polyneuropathy (CIDP), Guillain-Barre Syndrome (GBS), infectious inflamma tory neurological diseases (INID) and non-inflammatory neurological disease s (NND). We found that mean CSF apol) levels are significantly increased in patients with CIDP/GBS reflecting an acute blood-nerve barrier leakage. In contrast, MS is characterized by an increased intrathecal apoD release as measured by the apoD index. Thus, the results of our study provide the firs t evidence of an increased intrathecal production of apoD in MS. Moreover, we demonstrate that mean apoD indices are highest in MS patients at the tim e of their first clinical exacerbation. CSF apoD levels and apoD indices co rrelate with MS disease duration but not with disability or age. Finally, w e found that corticosteroid treatment resulted in significantly elevated CS F apoD levels. (C) 2001 Elsevier Science B.V. All rights reserved.