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Research Article| Volume 375, P123-128, April 15, 2017

Alzheimer's disease: Elevated pigment epithelium-derived factor in the cerebrospinal fluid is mostly of systemic origin

  • Author Footnotes
    1 These authors contributed equally to this study.
    Veronika Lang
    Footnotes
    1 These authors contributed equally to this study.
    Affiliations
    Department of Neurosurgery, Experimental Neurosurgery, Charité - Universitätsmedizin, Berlin, Germany

    Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin, Berlin, Germany
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  • Author Footnotes
    1 These authors contributed equally to this study.
    Marietta Zille
    Footnotes
    1 These authors contributed equally to this study.
    Affiliations
    Department of Experimental Neurology, Center for Stroke Research Berlin, Charité - Universitätsmedizin, Berlin, Germany

    Department of Neurology and Neuroscience, The Burke Medical Research Institute, Weill Medical College of Cornell University, White Plains, NY, USA
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  • Carmen Infante-Duarte
    Affiliations
    Experimental Neuroimmunology Research Group, Institute for Medical Immunology, Charité - Universitätsmedizin, Berlin, Germany,
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  • Sven Jarius
    Affiliations
    Molecular Neuroimmunology Group, Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
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  • Holger Jahn
    Affiliations
    Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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  • Friedemann Paul
    Affiliations
    NeuroCure Clinical Research Center, Charité - Universitätsmedizin, Berlin, Germany

    Department of Neurology, Charité - Universitätsmedizin, Berlin, Germany

    Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité – Universitätsmedizin Berlin, Berlin, Germany
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  • Author Footnotes
    1 These authors contributed equally to this study.
    Klemens Ruprecht
    Footnotes
    1 These authors contributed equally to this study.
    Affiliations
    Department of Neurology, Charité - Universitätsmedizin, Berlin, Germany
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  • Author Footnotes
    1 These authors contributed equally to this study.
    Ana Luisa Pina
    Correspondence
    Corresponding author at: Department of Neurosurgery, Experimental Neurosurgery/BCRT, Charité Universitätsmedizin, Campus Mitte, Chariteplatz 1/Virchowweg 21, Aschheim-Zondek-Haus 03-003, 10117 Berlin, Germany.
    Footnotes
    1 These authors contributed equally to this study.
    Affiliations
    Department of Neurosurgery, Experimental Neurosurgery, Charité - Universitätsmedizin, Berlin, Germany

    Berlin-Brandenburg Center for Regenerative Therapies, Charité - Universitätsmedizin, Berlin, Germany
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this study.
Published:January 17, 2017DOI:https://doi.org/10.1016/j.jns.2017.01.051

      Highlights

      • PEDF is increased in CSF of patients with AD, FTD, and bacterial meningitis.
      • PEDF is also elevated in serum of patients with AD.
      • Elevated PEDF in CSF of AD patients is mostly due to elevated PEDF in serum.
      • It is important to relate protein concentrations in CSF to serum concentrations.
      • This helps to avoid erroneous interpretations of increased protein in lumbar CSF.

      Abstract

      Pigment-epithelium derived factor (PEDF) is a neurotrophic factor with neuroprotective, anti-tumorigenic, and anti-angiogenic effects. Elevated levels of PEDF have previously been proposed as a cerebrospinal fluid (CSF) biomarker for Alzheimer's disease. However, the origin of PEDF in CSF, i.e. whether it is derived from the brain or from the systemic circulation, and the specificity of this finding hitherto remained unclear. Here, we analyzed levels of PEDF in paired CSF and serum samples by ELISA in patients with Alzheimer's disease (AD, n = 12), frontotemporal dementia (FTD, n = 6), vascular dementia (n = 4), bacterial meningitis (n = 8), multiple sclerosis (n = 32), pseudotumor cerebri (n = 36), and diverse non-inflammatory neurological diseases (n = 19). We established CSF/serum quotient diagrams to determine the fraction of intrathecally synthesized PEDF in CSF. We found that PEDF is significantly increased in CSF of patients with AD, FTD, and bacterial meningitis. Remarkably, PEDF concentrations were also significantly elevated in serum of patients with AD. CSF/serum quotient diagrams demonstrated that elevated PEDF concentrations in CSF of patients with AD are mostly due to elevated PEDF concentrations in serum. These findings underscore the importance of relating concentrations of proteins in CSF to their respective concentrations in serum to avoid erroneous interpretations of increased protein concentrations in lumbar CSF.

      Keywords

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