Expression of cellular retinoic acid-binding protein-I (CRABP-I) in the cerebrospinal fluid of adult onset moyamoya disease and its association with clinical presentation and postoperative haemodynamic change.

Abstract

OBJECTIVE:

The elevation of cellular retinoic acid-binding protein-I (CRABP-I) has been suggested as a candidate in the pathogenesis of paediatric moyamoya disease (MMD). However, few studies have addressed CRABP-I in adult onset MMD. The aim of this study was to examine the expression of CRABP-I in the cerebrospinal fluid (CSF) of adult onset MMD, and to evaluate its association with clinical presentation and postoperative haemodynamic change.

METHODS:

This study examined the CSF from 103 patients: bilateral MMD, n=58 (56.3%); unilateral MMD, n=19 (18.4%); atherosclerotic cerebrovascular disease (ACVD), n=21 (20.4%); and control group, n=5 (4.9%). The intensity of CRABP-I was confirmed by western blotting and expressed as the median (25th-75th percentile). The differences in CRABP-I expression according to disease entity (unilateral MMD vs bilateral MMD vs ACVD), initial presenting symptoms (haemorrhage vs ischaemia) and postoperative haemodynamic change (vascular reserve in single photon emission CT and basal collateral vessels in digital subtraction angiography) were analysed.

RESULTS:

CRABP-I intensities in bilateral MMD (1.45(0.86-2.52)) were significantly higher than in unilateral MMD (0.91(0.78-1.20)) (p=0.044) or ACVD (0.85(0.66-1.11)) (p=0.004). No significant differences were noted based on the initial presenting symptoms (p=0.687). CRABP-I was not associated with improvement in vascular reserve (p=0.327), but with decrease in basal collateral vessels (p=0.023) postoperatively.

CONCLUSIONS:

Higher CRABP-I in the CSF can be associated with typical bilateral MMD pathogenesis in adults. Additionally, postoperative basal collateral change may be related to the degree of CRABP-I expression.

• Authors: Jin Sue Jeon, Jun Hyong Ahn, Youn-Joo Moon, Won-Sang Cho, Young-Je Son, Seung-Ki Kim, Kyu-Chang Wang, Jae Seung Bang, Hyun-Seung Kang, Jeong Eun Kim, Chang Wan Oh
• Journal: Journal of neurology, neurosurgery, and psychiatry (J Neurol Neurosurg Psychiatry) Vol. 85 Issue 7 Pg. 726-31 (Jul 2014) ISSN: 1468-330X [Electronic] England
• PMID: 24292994 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Chemical References

• Receptors, Retinoic Acid
• retinoic acid binding protein I, cellular

Topics

• Adult
• Blotting, Western
• Brain (blood supply)
• Carotid Artery, Internal (diagnostic imaging, surgery)
• Female
• Hemodynamics (physiology)
• Humans
• Male
• Middle Aged
• Moyamoya Disease (cerebrospinal fluid, diagnostic imaging, etiology, physiopathology, surgery)
• Postoperative Period
• Prospective Studies
• Receptors, Retinoic Acid (analysis)
• Tomography, Emission-Computed, Single-Photon