Serum-soluble receptor for advanced glycation end product levels in patients with amyotrophic lateral sclerosis

OBJECTIVES

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease. There is evidence that oxidative stress is implicated in the pathophysiology of the neurodegenerative disorders, including ALS. Data from the literature suggests that the receptor for advanced glycation end products (RAGE) participates in pathological conditions, including oxidative stress and neurodegeneration.

MATERIALS AND METHODS

The study involved 20 patients with ALS and 20 patients from the control group. The serum-soluble RAGE (sRAGE) levels were measured using the enzyme-linked immunosorbent method.

RESULTS

The study showed that sRAGE levels are significantly decreased in serum of the patients with ALS comparing to the control group (P < 0.05). The correlation between the serum sRAGE levels and clinical parameters of the disease was not significant (P > 0.05).

CONCLUSIONS

The results indicate that sRAGE participates in pathophysiology of the ALS. It is possible that low sRAGE levels may influence neurodegeneration.

Decreased cerebrospinal fluid cytochrome c levels in patients with amyotrophic lateral sclerosis

OBJECTIVE

There is evidence showing impaired mitochondrial energy production and increased oxidative damage to mitochondria in amyotrophic lateral sclerosis (ALS). It is known that a lack of cytochrome c (CyC) in the mitochondrial intermembrane space can increase free radical release from mitochondria through interruption of the electron transport. CyC also plays a role in the apoptotic cell death which is suspected in ALS. The aim of the study was to measure cerebrospinal fluid (CSF) and serum CyC levels in patients with ALS.

MATERIAL AND METHODS

Forty ALS patients were diagnosed according to the El Escorial criteria of ALS. The clinical state of the patients was measured using the Amyotrophic Lateral Sclerosis Functional Rating Scale [ALSFRS].

RESULTS

It was shown that overall CyC levels were significantly decreased by 46 % in the CSF of patients with ALS compared with controls (p<0.05), and not affected in serum of patients with ALS (p>0.05). There was no significant difference in CyC levels in relation to the clinical parameters of the disease (p>0.05).

CONCLUSIONS

The study indicates that CyC may play a role in the pathogenesis of ALS. A possible mechanism is that increased neurodegeneration in ALS caused by free radical production decreases the concentrations of CyC.

Decreased serum endoglin level in patients with amyotrophic lateral sclerosis: a preliminary report

OBJECTIVES

Angiogenic mechanisms may have a role to play in the neurodegeneration observed in amyotrophic lateral sclerosis (ALS). The aim of the present study was to measure serum angiogenic factor endoglin (ENG) levels in patients with ALS.

MATERIAL AND METHODS

The study involved 25 ALS patients and 25 controls. Concentrations of ENG in serum samples were measured using a human Endoglin/CD105 ELISA kit (R&D Systems, Minneapolis, Minn., USA).

RESULTS

Serum ENG concentrations were 14 % lower in the patients with ALS compared to controls (4.57 versus 3.97 ng/mL; p<0.05). There was no significant difference in serum ENG levels between subgroups of patients with ALS subdivided depending on clinical state, type of ALS onset and duration of the disease (p>0.05). The correlation between serum ENG levels and clinical parameters of ALS was not significant either (p>0.05).

CONCLUSIONS

Results indicate that ENG may be implicated in the pathomechanism of ALS. A decrease in ENG levels, as observed in this study, may accelerate neurodegeneration of motor neurons in ALS through chronic ischaemia caused by impaired perfusion.

Decreased serum-soluble TRAIL levels in patients with amyotrophic lateral sclerosis

OBJECTIVES

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease. Previously, it was showed that apoptosis may play a role in the pathomechanisms of this disease. Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is a cytokine with proapoptotic activity in the central nervous system. The aim of the study was to measure serum TRAIL levels in patients with ALS.

MATERIALS AND METHODS

The study involved 25 patients with ALS and 20 controls. Serum TRAIL levels were performed by the enzyme-linked immunosorbent method.

RESULTS

Study showed that TRAIL levels were significantly decreased in the serum of patients with ALS compared with controls (P < 0.05). There was no significant correlation between serum TRAIL levels and clinical parameters of ALS (P > 0.05).

CONCLUSION

A decrease in serum TRAIL levels in patients with ALS suggests that this cytokine may be implicated in the pathomechanisms of this disease.

Cerebrospinal fluid Flt3 ligand level in patients with amyotrophic lateral sclerosis

OBJECTIVES

The Flt3 ligand (FL) is a cytokine with a neurotrophic and antiapoptotic activity in the central nervous system that induces the survival of neurons. The aim of the study was to measure levels of FL in amyotrophic lateral sclerosis (ALS) patients.

MATERIALS AND METHODS

The study involved 23 ALS patients and 23 people in the control group. The measurement of FL in the cerebrospinal fluid (CSF) and serum was performed by the enzyme-linked immunosorbent method.

RESULTS

Results showed that CSF FL levels were significantly increased in ALS patients compared with the controls (P < 0.05) but the serum levels of this cytokine did not differ from the controls (P > 0.05). There was no significant correlation between CSF and serum FL levels and clinical parameters of ALS (P > 0.05). The difference in CSF/serum ratio of FL between ALS patients and controls was not statistically significant (P > 0.05).

CONCLUSION

An increase in CSF FL levels in ALS patients, observed in this study, could be a compensative response for neurodegeneration but may also reflect increased diffusion of this cytokine into the central nervous system caused by blood-CSF barrier dysfunction.

Total antioxidant status is increased in the serum of amyotrophic lateral sclerosis patients

Oxidative stress may play an important role in the etiopathogenesis of amyotrophic lateral sclerosis (ALS). The aim of the study was to investigate serum total antioxidant status (TAS) level, a measure of peroxyl-scavenging capacity, in ALS patients. TAS level was determined by the colorimetric method in the serum from 28 ALS patients and 20 healthy control group subjects. The study revealed that serum TAS level was significantly higher in ALS patients compared with that in controls (p<0.05). There was no significant difference in TAS level between the groups of patients classified according to their age and sex, clinical state, type of ALS onset and duration of disease (p>0.05). The change of TAS level in ALS patients observed in this study suggests that oxidative stress may play an important role in neurodegeneration in ALS. An increase in plasma TAS level may be the result of endogenous protection mechanisms against free radical toxicity, but serum TAS level in ALS patients cannot be a marker of ALS duration, clinical state of patients and type of ALS onset.

Respiratory function in amyotrophic lateral sclerosis

The aim of this study was to examine the vital capacity (FVC) and forced expiratory volume in 1 s (FEV 1) in relation to the site of amyotrophic lateral sclerosis (ALS) onset and the duration of the disease. Respiratory involvement is the principal cause of death in ALS patients. The study was conducted at the Department of Neurology, University School of Medicine in Lublin. The study comprised 18 ALS patients. The average duration of ALS was 12 months. The patients were divided into two groups according to the site of ALS onset and into two groups according to the duration of the disease. FVC was significantly higher in the group of patients with a limb onset than in the group of patients with a bulbar onset of the disease. The study has shown respiratory function disturbances in ALS patients. FVC significantly depends on the site of ALS onset but not on the duration of the disease.

Effect of riluzole (Rilutek) treatment on plasma amino acid percentages in amyotrophic lateral sclerosis patients

The aim of the study was to investigate the effect of riluzole (Rilutek) treatment on plasma amino acids (AA) percentage capacity in amyotrophic lateral sclerosis (ALS) patients. Excitatory AA may be important in the pathogenesis of ALS. Riluzole is a neuroprotective drug that blocks glutamatergic neurotransmission in the central nervous system. The study was conducted at the Department of Neurology, University School of Medicine in Lublin. The study comprised 20 ALS patients. Plasma AA were measured by automated ion-exchange chromatography before and after 3 months of riluzole treatment. The study has shown a significant decrease in serine percentage capacity and a significant increase in isoleucine percentage capacity in the plasma of the ALS patients, however the plasma excitatory AA percentage capacity was not significantly changed after 3 months of the riluzole treatment. Our investigations revealed that riluzole does not significantly influence the majority of plasma AA percentage capacity in ALS patients.

Creatine kinase activity in amyotrophic lateral sclerosis patients

The aim of this study was to investigate creatine kinase (CK) in the serum of amyotrophic lateral sclerosis (ALS) patients. Previous investigations have shown an increased CK activity in ALS patients and this has been suggested to be an indicator of patients survival. The study was conducted at the Department of Neurology, University School of Medicine in Lublin. Thirty ALS patients took part in the study. The average duration of the disease was 17 months. Serum CK levels were measured by the enzymatic method with N-acethylcysteine. CK was elevated in 43.3% of the ALS patients. There were no significant differences in the serum CK level between the groups of the ALS patients depending on age, sex, duration of the disease, or clinical condition of patients. The CK level was significantly higher in the serum of the patients with a limb onset than in patients with a bulbar onset of ALS. Our study confirmed the increase in the serum CK activity in ALS patients. CK activity depends on a limb onset or a bulbar onset of ALS, but not on the duration of the disease and the severity of the clinical condition.

Plasma amino acids percentages in amyotrophic lateral sclerosis patients

The aim of the study was to examine plasma amino acids (AA) percentages in amyotrophic lateral sclerosis (ALS) patients. Altered metabolism of AA, especially excitatory AA in ALS, has been reported. The investigation was conducted at the Department of Neurology, University School of Medicine in Lublin. The study comprised 50 patients; 20 persons with ALS and 30 controls. Plasma AA were measured by automated ion-exchange chromatography. The results show significantly lower percentages of plasma tyrosine, valine, methionine, leucine, and isoleucine and significantly higher percentages of plasma glutamine and serine in ALS than in controls. The clinical state significantly influenced the percentage of plasma phenylalanine and alanine. Our study shows significant changes in some plasma AA percentages in ALS; however, excitatory AA percentages did not differ from the control subjects.

Prostaglandin E2 is increased in amyotrophic lateral sclerosis patients

OBJECTIVES

Oxidative stress and glutamate-mediated excitotoxicity may play an important role in the etiopathogenesis of amyotrophic lateral sclerosis (ALS). Prostaglandin E2 (PGE2) activity can be associated with motor neuron death by inducing free radical formation and glutamate release from astrocytes. The aim of this study was to determine PGE2 concentration in the serum and cerebrospinal fluid (CSF) of ALS patients.

MATERIAL AND METHODS

PGE2 concentration was measured by the enzyme-linked immunosorbent method in the serum and CSF from ALS and control group patients.

RESULTS

Serum and CSF PGE2 concentration was significantly higher in the whole group of ALS patients compared with the control group patients (P < 0.05). There was no relationship between PGE2 concentration and clinical parameters of the disease, such as clinical state, type of ALS onset, and duration of the disease (P > 0.05). A significant correlation between CSF PGE2 concentration and age of control group patients was found (P < 0.05).

CONCLUSIONS

A significant increase in serum and CSF PGE2 concentration, in ALS patients observed in this study, indicates that PGE2 may play a role in neurodegeneration of ALS through oxidative damage of neurons and glutamate-mediated excitotoxicity. It suggests that inhibition of PGE2 synthesis could prevent motor neuron death. However, serum and CSF PGE2 cannot be a marker of the type of ALS onset, clinical state of patients, or the duration of the disease.

Plasma amino acids concentration in amyotrophic lateral sclerosis patients

Previous investigations showed an impairment of amino acids (AA) metabolism in amyotrophic lateral sclerosis (ALS). It was hypothesized that excitatory AA may play an important role in the etiopathogenesis of this disease. The aim of the study was to determine plasma AA concentrations in ALS patients, and to examine the relationship between AA and the clinical state of ALS patients, the type of ALS onset and the duration of the disease. The study involved 20 ALS patients and 30 control group people. The AA analysis was performed by ion - exchange chromatography on an automatic AA analyser. The results showed significantly decreased concentrations of valine, isoleucine, leucine, tyrosine and aspartate in the plasma of the whole group of ALS patients compared to the control group, and a significantly decreased concentration of arginine in the patients with a long duration of ALS compared to the patients with a short duration. The clinical state of ALS patients significantly influenced only plasma alanine concentration. Other plasma AA concentrations were not significantly associated with clinical parameters of the disease. Our study confirms that metabolic abnormalities concerning AA exist in ALS patients. However, the normal plasma glutamate concentration observed in this study in the whole group of ALS patients compared to the controls does not exclude that this excitatory AA may play a role in neurodegeneration in ALS.

Endogenous protectant kynurenic acid in amyotrophic lateral sclerosis

OBJECTIVES

Excitotoxicity may play a role in neurodegeneration in amyotrophic lateral sclerosis (ALS). Kynurenic acid (KYNA), an endogenous antagonist of excitatory amino acid receptors, may inhibit excitotoxic lesions. The aim of this study was to determine the concentration of KYNA in ALS patients.

MATERIAL AND METHODS

KYNA was measured by high-performance liquid chromatography in the serum and cerebrospinal fluid (CSF) from ALS and control patients.

RESULTS

Our study revealed that CSF KYNA concentration was significantly higher in patients with bulbar onset of ALS compared to controls, and compared to patients with limb onset of the disease. CSF KYNA was also higher in patients with severe clinical status compared to controls. Serum KYNA was significantly lower in ALS patients with severe clinical status compared to controls, and compared to patients with mild clinical status. There were no significant differences in CSF and serum KYNA concentration between the whole ALS group of patients and controls. There was no difference in CSF KYNA concentration between males and females, and there was no correlation between KYNA concentration and age of patients, and duration of ALS.

CONCLUSIONS

An increased CSF KYNA concentration in patients with bulbar onset of ALS and in patients with severe clinical status may indicate neuroprotective role of KYNA against excitotoxicity. The difference of KYNA concentration in CSF of patients with bulbar and limb onset of ALS suggests that these two variants of motor neuron disease may have different etiopathogenetic mechanisms.

[Matrix metalloproteinase-9 (MMP-9) activity in cerebrospinal fluid of amyotrophic lateral sclerosis patients]

Matrix metalloproteinase-9 (MMP-9) is a member of the family of zinc-dependent endopeptidases that degrade extracellular matrix proteins. It can be activated by serine proteinases or by superoxide radicals. The motor neurons in amyotrophic lateral sclerosis patients express significantly higher levels of MMP-9, suggesting a role in neurodegeneration. The aim of the study was to investigate MMP-9 in cerebrospinal fluid from amyotrophic lateral sclerosis patients. MMP-9 was measured by enzyme-linked immunosorbent assay ELISA in cerebrospinal fluid from 24 amyotrophic lateral sclerosis patients and 15 controls. The mean amyotrophic lateral sclerosis duration was 18 months. According to Munsat ALS Health State Scale, the patients were divided into four groups: mild, moderate, severe, terminal. The patients were also divided into groups with shorter (below 12 months) and longer (above 12 months) duration of the disease. MMP-9 level was insignificantly lower in the cerebrospinal fluid from amyotrophic lateral sclerosis patients compared with controls. MMP-9 level showed a tendency to decrease with clinical status worsening, however this correlation was not statistically significant. The difference between MMP-9 level in the cerebrospinal fluid between the groups of patients with shorter and longer duration of amyotrophic lateral sclerosis was not significant.

[Thrombogenesis in patients with ischemic stroke]

The activity of thrombinogenesis process is shown by thrombin restrain reaction by its physiological inhibitor antithrombin III, as a result of which biologically nonactive thrombinantithrombin III complexes (TAT) are created. The aim of the study was to evaluate TAT complexes in the blood of ischaemic stroke patients. 25 persons with ischaemic stroke and 15 controls took part in the examination. Taking into consideration brain CT outcomes 2 groups of patients were selected: with ischaemic stroke of small and great extent. The patients were also divided into a group of patients with less severe and with more severe ischaemic stroke, and into a group of patients with ischaemic stroke with and without accompanying atrial fibrillation. TAT complexes were determined with an enzyme-linked immunosorbent assay method on days 1st, 5th, and 12th after ischaemic stroke onset. TAT complexes were significantly higher in patients with cerebral infarction than in controls, significantly higher in patients with ischaemic stroke of great extent compared to patients with ischaemic stroke of small extent, and significantly higher in patients with more severe cerebral infarction than in patients with less severe cerebral infarction. In patients with cerebral infarction and atrial fibrillation TAT complexes were significantly higher only on the 1st day of the disease compared to patients with cerebral infarction without atrial fibrillation. Our investigations confirm intense activity of thrombinogenesis process in ischaemic stroke patients.

Interleukin-1beta converting enzyme/Caspase-1 (ICE/Caspase-1) and soluble APO-1/Fas/CD 95 receptor in amyotrophic lateral sclerosis patients

OBJECTIVES

The aim of the study was to investigate the role of ICE/ Caspase-1 and soluble APO-1/Fas/CD 95 receptor in amyotrophic lateral sclerosis patients.

MATERIAL AND METHODS

The apoptosis parameters were measured by enzyme-linked immunosorbent assay (ELISA) in serum and cerebrospinal fluid from 25 amyotrophic lateral sclerosis and 15 control patients.

RESULTS

There has been shown a significant increase of ICE/Caspase-1 level in serum, and significant decrease of this parameter in cerebrospinal fluid from amyotrophic lateral sclerosis patients. Soluble APO-1/Fas/CD 95 level in amyotrophic lateral sclerosis patients did not differ from the control group. There was no significant correlation between clinical status, duration of amyotrophic lateral sclerosis, and levels of ICE/Caspase-1 and soluble APO-1/Fas/CD 95.

CONCLUSION

Our study suggests that ICE/Caspase-1 may play a role in neurodegeneration in ALS. Due to ethical difficulties we cannot include patients suffering from progressive neurological diseases, who are a more appropriate control group for the amyotrophic lateral sclerosis patients. Therefore we are limited in drawing conclusions from the research.

[Superoxide dismutase-1 (SOD-1) gene mutation-dependent mechanisms of neural degeneration in amyotrophic lateral sclerosis]

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease involving motor neuron degeneration, occurring in sporadic and familial forms. Mutations in Cu/Zn superoxide dismutase gene (SOD-1) play a key role in the pathogenesis of the familial form in which it is present in about 20%. The mechanisms by which the mutated enzyme produces the disease are not sufficiently know. The following hypothesis are considered: oxidative damage, disorganization of neurofilaments, toxic action of intracellular aggregates, disturbed mechanisms of protein synthesis or degradation, and increased glutamic acid toxicity due to damage of EAAT 2 mRNA, transporter of this acid. It is supposed that motor neuron death is due to various mechanisms caused by SOD-1 enzyme mutations. Pathological changes suggest that biochemical processes leading to neurodegeneration in familial ALS form related or unrelated to SOD-1 mutation, and in sporadic form may be very similar.

[A case of polymyositis with flaccid paraparesis]

Polymyositis is characterized by inflammatory process in muscles and muscle weakness is the main clinical sign of the disease. We report a case of a 65-years old woman suffering from polymyositis with flaccid paraparesis. Forms of polymyositis where only proximal muscles of lower extremities are involved are very rare, so it may cause diagnostic mistakes. Because of that, it is very important to pay a special attention when making the diagnose of paresis.

[A case of hypoxic encephalopathy in the course of chronic spastic bronchitis and pulmonary emphysema]

Respiratory insufficiency appearing during chronic lung diseases leads to hypoxemia, hypercapnia, acidosis, right ventricular failure and secondary polyglobulia. These disturbances lead to respiratory encephalopathy which is characterized by the appearance of various types of neurological syndromes. We present here the case of a patient suffering from chronic spastic bronchitis accompanied by pulmonary emphysema, whose consciousness disturbances, a generalized epileptic seizure and hemiparesis were connected with his respiratory insufficiency intensifying during the basic disease. Removal of metabolic disturbances caused by respiratory insufficiency has a key role in preventing secondary neurological syndromes.

[Total magnesium in serum and cerebrospinal fluid in patients with amyotrophic lateral sclerosis]

The significance of trace elements in the aetiopathogenesis of ALS is still unknown. Magnesium plays an essential role in fundamental cellular reactions. The aim of this study was to estimate total magnesium concentration in serum and cerebrospinal fluid of ALS patients. 15 persons with ALS and 12 controls took part in the examination. Magnesium was determined by spectrophotometric atomic-absorption method. Total magnesium concentration in serum of ALS patients was statistically insignificant lower than in the control group, but in cerebrospinal fluid was it statistically insignificantly higher than in the control group. Outcomes of our own investigations do not show any essential role of magnesium in the aetiopathogenesis of ALS.

[Practical significance of ischemic stroke OCSP (Oxfordshire Community Stroke Project) classification]

OCSP classification based on neurological signs and syndromes contains four subtypes of ischaemic stroke: lacunar infarct (LACI), total anterior circulation infarcts (TACI), partial anterior circulation infarcts (PACI), posterior circulation infarcts (POCI). Literature reports suggest that this classification may be useful in estimation of after stroke complications and prognostication, and can raise the sensitivity of therapeutic clinical tests. The aim of this study was to estimate the occurrence of risk factors, accompanying complications and prognosis in a material of clinical records of 346 hospitalized patients. Attention is drawn to limited importance of brain CT as shown in frequent discordance between clinical syndromes and CT findings in establishing to which stroke subtype a given patient belongs. The results obtained in the study are highly similar to those reported from other clinical centres. It was found that PACI syndrome was most frequently occurring, and that TACI subtype was associated with the highest frequency of complications and risk factors, and worst prognosis. The prognosis was best in the LACI subtype. The subtype of OCSP classification seems to be determining the possibility of complications and prognosis, and could suggest the most effective medical treatment.

[Myelomatous meningitis: a case report]

Multiple myeloma is characterized by the production of a monoclonal immunoglobulin. Myelomatous meningitis is a rare occurrence in multiple myeloma. The signs of meningeal myelomatosis include impairment of consciousness, cranial nerve palsies, convulsions and plasmatic cells in the cerebrospinal fluid. Atypical, plasmatic cells in the cerebrospinal fluid are an important finding for the diagnosis of meningeal myeloma. A combination of radiation therapy and chemotherapy is the usual treatment. Patients with meningeal myelomatosis can have a good response to treatment initially, but their prognosis is poor and death occurs within a few months. We present the case of a woman with myelomatous meningitis. Multiple myeloma was diagnosed by serum protein electrophoresis and bone marrow aspiration. This case and a review of the literature show that clinical manifestations of meningeal myeloma are non-specific.

[Acute phase proteins: alpha-1-acid glycoprotein (AGP) and alpha-1 antichymotrypsin (ACT) in serum of patients with cerebral ischemic stroke]

The purpose of this study was to investigate the dynamics of selected acute phase proteins in serum of patients with cerebral ischaemic stroke. The investigation was done in 30 patients with cerebral ischaemic stroke. Alpha1-acid glycoprotein and alpha-1-antichymotrypsin levels in serum of patients with cerebral ischaemic stroke on III and VII day of illness were statistically significantly higher than in the control group.

[The value of sialic acid for diagnosis of nervous system diseases]

The purpose of this study was to present the biological role of sialic acid and to investigate the concentration of this parameter in serum of patients with different diseases. The study presented the measurement of plasma sialic acid in patients with nervous system pathology with special regard to cerebral strokes. The investigation of the dynamics of sialic acid in serum of patients may be helpful in diagnosing patients with different pathology.

The protective role of ceruloplasmin against the activity of free radicals in brain ischaemia

Free radicals are atoms, groups of atoms or particles having on their last orbital at least one unpaired electron. This feature decides about their great chemical reactivity and lability (12, 16). To potentially toxic oxygen radicals belong: peroxidal anion radical, hydroxidal radical, hydrogen peroxide, hydroxylic radical, peroxidal lipid radical, singletal oxygen (12). The presence of free radicals in biological systems may play a role in etiopathogenesis of different illnesses. Overactivity of these compounds causes damage of tissues and bodily organs (3, 16, 18).

The structure and function of blood-brain barrier in ischaemic brain stroke process

The central nervous system both anatomically and functionally has a certain autonomy in comparison with the rest of the system thanks to the so called barriers dividing brain from both blood and cerebro-spinal fluid. Capillary vessels in brain are additionally surrounded by protoplasmic process of neuroglial cells. They are astrocytes which by means of protoplasmic process hermetically surround capillary vessels from the outside. Owing to that astrocytes create an additional layer, that has to be overcome by chemical compounds circulating in blood (2). Brain barrier fulfils an immunological function. It protects brain tissue against fluctuations in concentration of respective components occurring in blood plasma and against destructive blood components (2, 7). Lowering of brain flow of blood below 10-15 ml/100 g/min causes deficit of glucose and oxygen, indispensable for proper oxido-reductive processes. The most important factor determining brain tissue damage is a constant shortage of high energetic phosphate. Damage to mechanisms depending on energy causes ischaemic depolarisation phenomenon, after which potassium ions come out of cells and sodium and calcium ions come into them. Neurotransmitters, stimulating amino acids including, are being freed in a quantity that is conductive to toxic activity. Fall of blood flow causing acidosis provokes disturbances in vessel self-regulation, and lactates created are additional factor that damages tissues. Pathophysiological changes mentioned above lead to heavy injury and death of cells (3, 12). The intensifying acidosis and the process of maturing of morphological changes in ischaemic focus cause a rise in penetrability of blood-brain barrier (1, 2, 8). Works considering behaviour of blood-brain barrier in the process of brain stroke, are for the most part based on experimental models.

Cerebral strokes immunopathology

The central nervous system considering its structure, metabolism and function is one of the most complex bodily organs. It is the main system controlling and coordinating all vital functions of the organism. As a result of cerebral strokes disorders of the entire metabolic system occur. They are characterized by disregulation of carbohydrate, lardaceous, proteinaceous and water-electrolytic economy (7, 11). Immunological disorders occurring in cerebral stroke process are a secondary phenomenon, but they do influence in an essential way the course of the disease (15).

The biological role of haptoglobin and behaviour of this protein in different diseases, with special attention paid to brain stroke

Haptoglobin (Hp) is an alpha 2 glycoprotein, the presence of which was determined in blood serum in 1940 by Polonovski and Jayle. Smithies showed genetically conditioned polymorphism of haptoglobin (4, 16). Molecular heterogeneity of haptoglobin is demonstrated by three main phenotypes: Hp 1-1, Hp 2-2, Hp 2-1. Haptoglobin is a glycoprotein with tetrametric structure. Haptoglobin 1-1 is composed of two alpha (light) chains with 9,000 molecular mass including 83 amino acids and two beta (heavy) chains with 40,000 molecular mass including 245 amino acids. Alpha chains are connected with each other by two sulfurous bonds which also connect alpha chains with beta chains (3, 4).

[The value of measuring acute phase protein level in pathologic cases with particular attention to nervous system diseases]

Based on Polish and foreign literature the up-to-date knowledge on usefulness of measurement of the level of acute phase proteins in clinical diagnostics is presented. Acute phase proteins may serve as a quick, preliminary test which indicates bacterial infection or necrotic process. They are good markers of treatment efficacy and infectious (bacterial) complications in patients in a hopeless state or with a chronic disease. In neurological diagnostics they are useful in differentiation of bacterial and viral meningitis.

[Acute phase factors in blood of patients with subarachnoid hemorrhage in its earliest phase]

The purpose of the study was to investigate the dynamics of acute phase reactants concentrations in the blood changes of patients with subarachnoid haemorrhage in the earliest period of illness. The investigation was carried out in 20 patients with subarachnoid haemorrhage. The total sialic acid, haptoglobin and ceruloplasmin level in the blood of patients with subarachnoid haemorrhage was statistically significantly higher than in the control group.