Cerebrospinal fluid cholesterols and phospholipids in multiple sclerosis.

Abstract

Lipids were extracted from cerebrospinal fluid (CSF) samples from 46 patients with multiple sclerosis (MS). Unesterified and esterified cholesterol, total phospholipid, sphingomyelin, choline phosphoglyceride, and ethanolamine phosphoglyceride were separated by thin layer chromatography and determined quantitatively. CSF cholesterol and phospholipid concentrations were correlated with CSF protein concentrations. The mean concentrations of phospholipids were decreased in MS. The relative concentration of esterified cholesterol was increased and that of ethanolamine phosphoglyceride decreased in this disease. Low concentrations predominated in patients with latent probable MS and in patients with slight or no disability. Patients with a recent exacerbation of symptoms and the most severely disabled patients showed a relative increase of esterified cholesterol and a decrease of ethanolamine phosphoglyceride, but these findings were not significant. It is discussed, whether these alterations may be a CSF reflection of changes of CNS lipid composition and metabolism in MS. From a clinical point of view, the determination of CSF cholesterol and phospholipid concentrations seems to be of little help due to the great variation in the concentrations in normal persons and in patients with MS.