β‐Trace protein in cerebrospinal fluid: A blood–CSF barrier–related evaluation in neurological diseases

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Abstract
β-Trace protein concentrations in cerebrospinal fluid (CSF) and serum from 113 patients with variuos neurological diseases and 65 controls were determined with a sensitive and specific immunonephelometric assay. In adult control patients, β-trace concentrations were 14.6 ± 4.6 mg/L in CSF and 0.46 ± 0.13 mg/L in serum, that is 32-fold higher in CSF. β-trace levels in CSF correlated with age as well as with the albumin CSF/serum ratio (QA1b), which is considered a measure for blood-CSF barrier function. The relationship between CSF β-trace levels and elevated QA1b values was studied in various neurological diseases with CSF protein increase. In spinal canal stenosis, CSF β-trace (mean = 29.5 ± 10.5 mg/L) correlated positively with increasing QA1b values. In bacterial meningitis, CSF β-trace (mean = 8.7 ± 3.9 mg/L) remained invariant to changes of QA1b values. In Guillain-Barre syndrome, CSF β-trace (mean = 14.4 ± 6.8 mg/L) was below the QA1b-dependent reference range. In multiple sclerosis and viral meningoencephalitis, β-trace levels were within the reference range. β-Trace concentration in CSF can be used in conjunction with QA1b to distinguish between different neurological pathologies associated with CSF protein increase.