Abstract

To examine the developmental profile of myelin basic protein-like material (MBPLM) in urine. If urinary MBPLM exhibits a developmental profile corresponding to that of forebrain myelination, certain inferences should follow deviations from normal. Thus, MBPLM might provide a marker for monitoring the neurodevelopmental status in infants at risk for adverse outcomes. MBPLM in different immunochemical forms is detectable in human CSF and urine, presumably a result of myelin basic protein (MBP) catabolism. Urinary MBPLM has been used successfully as a marker of disease status in adults with MS. Urinary MBPLM increases in MS patients changing from a relapsing-remitting to a progressive course, possibly reflecting attempted or failed remyelination. Scant information exists concerning the presence or specific levels of urinary MBPLM during infancy and childhood when myelination is most active. MBPLM was assayed in 402 urine specimens from 398 infants and children ranging in age from birth to 17 years according to previously described methods. MBPLM is detectable in urine from newborns, although at substantially lower levels than in adults (157.3 +/- 83.9 ng/mg creatinine). Whether expressed as nanograms per milliliter urine or nanograms per milligram creatinine, MBPLM levels are lower (p < 0.05) from birth through 12 months and greater (p < 0.05) between ages 2 to 8 years than in adults. Human urinary MBPLM exhibits a developmental profile that parallels the onset of normal myelination and exceeds normal adult values through early childhood. Thus, urinary MBPLM could serve as a useful marker of myelination in the developing child.

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