Elevated Biopterin and Homovanillic Acid Levels in Cerebrospinal Fluid From Children With Aseptic Meningitis

Abstract

To examine biopterin fractions and biogenic amine metabolites in cerebrospinal fluid in aseptic meningitis, the concentrations of homovanillic acid, 5-hydroxyindoleacetic acid, and the total, the oxidized form, and the reduced form of biopterin were determined in cerebrospinal fluid specimens from 15 children with aseptic meningitis in the acute phase, 15 children with aseptic meningitis in the recovery phase, and six other children as controls. The concentration of each substance was significantly higher in the acute phase than in the recovery phase. Homovanillic acid in the acute phase was significantly increased compared to that in the control group. The concentrations of the total, the oxidized form, and the reduced form of biopterin, and 5-hydroxyindoleacetic acid were higher in the acute phase than those in the controls; however, the differences were not significant. The concentration of each substance in the recovery phase was not significantly different from that in the controls. There was no difference in the 5-hydroxyindoleacetic acid/homovanillic acid ratio or in the reduced form/total biopterin ratio among the patients in acute and recovery phases and the controls. These results suggested that levels of biopterin and biogenic amine metabolites in cerebrospinal fluid are increased in the acute phase of aseptic meningitis and return to normal during the recovery phase. This is the first report of increased concentrations of biopterin fractions and biogenic amine metabolites in aseptic meningitis.

Effect of age on cerebrospinal fluid levels of metabolites of biopterin and biogenic amines

“…The CSF levels of each metabolite observed in the present study were similar to those reported previously (9)(10)(11)(12). We added the data from the patients with aseptic meningitis in recovery phase to those of the controls because we previously determined that the levels of biopterin and biogenic amine metabolites in patients with aseptic meningitis in recovery phase are comparable to those of controls (7).…”

“…Samples were assayed within 1 mo of collection. CSF levels of biopterin, HVA and 5-HIAA were determined by high-performance liquid chromatography, as described previously (7). Data were analysed using the SAS/STAT system for personal computers.…”

“…It has recently been discovered that the level of biopterin in cerebrospinal fluid (CSF) is altered in many neurological disorders, i.e. decreased in phenylketonuria due to biopterin deficiency (1), Parkinson's disease (2,3), Alzheimer's disease (4), depression (1), hereditary progressive dystonia with marked diurnal fluctuation (5) and autistic behaviour (6); and increased in inflammation of the central nervous system in the acute phase (1,7) and in Rett syndrome (8).…”

Sulfamethoxazole-trimethoprim double-blind, placebo-controlled, crossover trial in Machado-Joseph disease: sulfamethoxazole-trimethoprim increases cerebrospinal fluid level of biopterin

“…0.4ml CSF or 0.3ml serum was collected into a tube containing iodine in 0.1N HC1 or 0.1N NaOH, shaken, and stored at -80~ until assay. After each sample was subjected to partial purification on a Dowex 50 column, it was injected into a high performance liquid chromatograph (Komori et al, 1994). The sample after acid oxidation represents the total biopterin (total B; BH4, quinonoid dihydrobiopterin, BH2, and biopterin), and the sample after alkaline oxidation represents the oxidized form of biopterin (oxidized B; BH2 and oxidized biopterin).…”

Difficulties in establishing reference intervals for special fluids: the example of 5-hydroxyindoleacetic acid and homovanillic acid in cerebrospinal fluids

“…• regulation of enzyme activity (i.e., phosphorylation) and other minor interactions, such as the regulatory action of serotonin turnover on dopamine turnover, the latter helps explain the interdependence of 5-HIAA and HVA in CSF (11,12); • availability of amino acid precursors (13) and transport; impaired transport of tyrosine and tryptophan has been implicated in aminoamine disturbances in schizophrenia (14), HIV infection (15) and untreated phenylketonuria (16); • inter-individual genetic heterogeneity (17) due to DNA polymorphism in genes of enzymes involved in the synthesis and catabolism of monoamines; • rate of reuptake/egress: variability between individuals in the transport process (probenecid-sensitive organic anion transport system) may also contribute to the variability of lumbar HVA and 5-HIAA concentrations; • rate of CSF formation.…”