Abstract
The clinical application of a newly developed highly sensitive ELISA method (20) to
assay glial fibrillary acidic protein (GFAP) in the cerebrospinal fluid (CSF) was
investigated in children and adolescents with neurological disorders. GFAP analysis
was explored as a tool to differentiate disorders with ongoing astrocytosis. A consecutive
series of 34 subjects, 17 boys and 17 girls, with nonprogressive and progressive neurological
encephalopathies was compared to 10 healthy controls. The mean CSF GFAP concentration
of the controls was 60.6 ± 54 ng/l (SD). The group of 24 subjects (12 boys and 12
girls) with progressive neurologic disorders had higher mean CSF GFAP levels than
the group of 10 subjects (5 boys and 5 girls) with non-progressive disorders, 222.6
± 186 and 127.5 ± 86 ng/l, respectively. The progressive encephalopathies differed
significantly from controls (p < 0.01) while the non-progressive did not. The mean
GFAP concentration of the epilepsy cases (n = 18) and non-epilepsy cases (n = 16)
was 212.9 ± 196 and 174.0 ± 132 ng/l, respectively. The epilepsy cases differed significantly
from controls which could be explained by the dominance of progressive cases (15 out
of 18). Six subjects with known gliotic progressive disorders (glutaric aciduria Type
1, Unverricht-Lundborg disease, Hallervorden-Spatz disease, Jansky-Bielschowsky disease
and juvenile Huntington disease) differed significantly, as expected, from controls
with a mean CSF GFAP concentration of 326.2 ± 132.5 ng/l, p < 0.001. The group with
Lennox-Gastaut syndrome (3 boys and 3 girls) also differed significantly from controls
(205.0 ± 107.6, p<0.01). The findings provide support for a correlation between clinically
progressive neurological disorders in children and elevated CSF GFAP.
Key words
GFAP - Gliotic process - Encephalopathy - Epilepsy
