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. 2022 Aug 14;44(8):3666-3680.
doi: 10.3390/cimb44080251.

Basic Analysis of the Cerebrospinal Fluid: An Important Framework for Laboratory Diagnostics of the Impairment of the Central Nervous System

Petr Kelbich  1   2   3 , Karel Hrach  1   4 , Jan Spicka  1 , Petr Vachata  5   6 , Tomas Radovnicky  5 , Eva Hanuljakova  1   3 , Jan Krejsek  2
Affiliations

Basic Analysis of the Cerebrospinal Fluid: An Important Framework for Laboratory Diagnostics of the Impairment of the Central Nervous System

Petr Kelbich et al. Curr Issues Mol Biol. .

Abstract

Laboratory analysis of basic cerebrospinal fluid (CSF) parameters is considered as essential for any CSF evaluation. It can provide rapidly very valuable information about the status of the central nervous system (CNS). Our retrospective study evaluated parameters of basic CSF analysis in cases of either infectious or non-infectious CNS involvement. Neutrophils are effector cells of innate immunity. Predominance of neutrophils was found in 98.2% of patients with purulent inflammation in CNS. Lymphocytes are cellular substrate of adaptive immunity. We found their predominance in 94.8% of patients with multiple sclerosis (MS), 66.7% of patients with tick-borne encephalitis (TBE), 92.2% of patients with neuroborreliosis, 83.3% of patients with inflammatory response with oxidative burst of macrophages in CNS and 75.0% of patients with malignant infiltration of meninges (MIM). The simultaneous assessment of aerobic and anaerobic metabolism in CSF using the coefficient of energy balance (KEB) allows us to specify the type of inflammation in CNS. We found predominantly aerobic metabolism (KEB > 28.0) in 100.0% CSF of patients with normal CSF findings and in 92.8% CSF of patients with MS. Predominant faintly anaerobic metabolism (28.0 > KEB > 20.0) in CSF was found in 71.8% patients with TBE and in 64.7% patients with neuroborreliosis. Strong anaerobic metabolism (KEB < 10.0) was found in the CSF of 99.1% patients with purulent inflammation, 100.0% patients with inflammatory response with oxidative burst of macrophages and in 80.6% patients with MIM. Joint evaluation of basic CSF parameters provides sufficient information about the immune response in the CSF compartment for rapid and reliable diagnosis of CNS involvement.

Keywords: aspartate aminotransferase; blood-brain barrier; blood-cerebrospinal fluid barrier; cerebrospinal fluid; coefficient of energy balance; cytological-energy analysis.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Schematic representation of CSF production. BCB: Blood-Cerebrospinal Fluid Barrier; BBB: Blood-Brain Barrier.
Figure 2
Figure 2
CSF total protein concentrations in our patient groups (*: statistically significant).
Figure 3
Figure 3
CSF leukocyte counts in our patient groups (*: statistically significant).
Figure 4
Figure 4
Percentage of lymphocytes in CSF in our patient groups (*: statistically significant).
Figure 5
Figure 5
Percentage of neutrophils in CSF in our patient groups (*: statistically significant).
Figure 6
Figure 6
Percentage of monocytes in CSF in our patient groups (*: statistically significant).
Figure 7
Figure 7
Distribution of KEB values in subgroups of our patients (*: statistically significant).
Figure 8
Figure 8
Catalytic activities of AST in CSF in our patient groups (*: statistically significant).
See this image and copyright information in PMC

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