Scripties UMCG - Rijksuniversiteit Groningen
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The Relationship between Blood-Brain Barrier Function and Inflammatory Markers in Blood and Cerebrospinal Fluid : An Anaesthetic Biobank of Cerebrospinal Fluid Study

(2019) Freeman, C. (Christopher)

The blood-brain barrier (BBB) is the highly selective anatomical border between the systemic circulation and central nervous system comprised of endothelial cells surrounding the cerebrovascular lumen. The purpose of the BBB is to maintain homeostasis in the central nervous system by preventing diffusion of toxic matter and pathogens into the brain. Research has shown in recent years that systemic inflammation can have consequences for the function of the BBB and can compromise its integrity. This can be harmful in the acute context as well as chronic as changes in the BBB are thought to be implicated in the development and progression of various neurological diseases. Current methods of measuring BBB function are dependent on the examination of the ratio of albumin (Qalb) between blood and cerebrospinal fluid (CSF) (as well as other invasive and intensive methods). Systemic inflammation can be indicated by raised blood leucocytes and aberrant blood glucose levels. This study examined whether or not blood leucocyte and glucose measurements were sufficient to reliably predict Qalb. This study also examined by way of various models the reliability of the aforementioned blood measurements, CSF measurements and biographic data in predicting Qalb. Blood and CSF were obtained from 275 study participants and analysed for leucocytes, glucose and albumin. Qalb was calculated for each patient by dividing CSF albumin by blood albumin concentration. Blood leucocyte measurements were not shown to be significantly predictive of Qalb in any model (p=0.280). Outcomes of the various models showed that Qalb was consistently significantly correlated with blood glucose (p=<0.001) and age (p=<0.001). Other variables showed mixed results. Model goodness of fit for the prediction of Qalb was shown to increase with progressive inclusion of variables. It is therefore suggested on the basis of these results that the future development of a reliable predictive model for Qalb is possible and could provide valuable insights for the diagnoses, progression and treatment of neurological disease.

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