Elevated levels of ferritin in the cerebrospinal fluid of amyotrophic lateral sclerosis patients

Acta Neurol Scand. 2017 Aug;136(2):145-150. doi: 10.1111/ane.12708. Epub 2016 Nov 1.

Abstract

Objectives: The aim of the study was to detect changes in the levels of ferritin heavy chain (FHC), ferritin light chain (FLC), and transferrin in the cerebrospinal fluid (CSF) and serum of amyotrophic lateral sclerosis (ALS) patients and to analyze the correlations between the levels of these proteins and various clinical parameters.

Methods: Cerebrospinal fluid and serum samples were obtained from 54 ALS patients and 46 non-inflammatory neurological disease control (non-INDC) patients. CSF and serum FHC, FLC, and transferring levels were measured via the enzyme-linked immunosorbent method using a commercial ELISA kit, and the times from onset (durations), ALS functional rating scale-revised (ALSFRS-r) scores, and disease progression rates (DPRs) were analyzed by registered neurologists. Statistical analysis was performed via Prism software.

Results: Compared with controls, ALS patients exhibited significantly increased FHC and FLC levels in CSF, which were positively correlated with DPR and negatively correlated with duration. Serum transferrin levels were significantly increased in ALS patients but were not correlated with disease progression. FHC and FLC in CSF rapidly increased as the disease worsened.

Conclusions: This study demonstrated that the clinical measurement of FHC and FLC in CSF may be beneficial for disease differentiation and evaluating progression in patients with ALS. Compared with levels in serum, the levels of FHC and FLC in CSF might be more reliable for diagnosing and assessing the progression of ALS.

Keywords: amyotrophic lateral sclerosis; amyotrophic lateral sclerosis functional rating scale-revised; cerebrospinal fluid; disease progression rate; ferritin; serum.

MeSH terms

  • Adult
  • Amyotrophic Lateral Sclerosis / blood
  • Amyotrophic Lateral Sclerosis / cerebrospinal fluid*
  • Amyotrophic Lateral Sclerosis / diagnosis*
  • Biomarkers / blood
  • Biomarkers / cerebrospinal fluid
  • Disease Progression*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Ferritins / blood
  • Ferritins / cerebrospinal fluid*
  • Humans
  • Male
  • Middle Aged

Substances

  • Biomarkers
  • Ferritins