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Abstract
The present study concerns an ELISA for glial fibrillary acidic protein (GFAP) in
cerebrospinal fluid (CSF). The application of the method in CSF of children has previously
been described in this journal. We have now adapted the technique to allow determination
of the much higher GFAP concentrations found in normal and pathological CSF of adults.
The assay range was extended to 16,000 pg/ml. CSF levels as high as 170,000 pg/ml
could be assayed since dilution experiments indicated immunological identity between
purified GFAP and GFAP in CSF. In normal controls the concentrations correlated significantly
with age (P < 0.001, Spearman rank correlation test). The concentrations were less
than 200 pg/ml before 20 years of age and increased to between 500 and 1300 pg/ml
at approximately 75 years of age. This increase of CSF GFAP probably reflects formation
of astroglial filaments in the CNS and it must be taken into consideration when determining
the pathological CSF GFAP level. The method was validated using CSF samples from patients
with either astrogliosis or acute tissue destruction in the CNS. Although augmented
levels were observed in both groups it is quite clear that patients with acute tissue
destruction may display very high CSF GFAP concentrations, whereas levels in patients
with astrogliosis were only modestly increased if at all.