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(Stroke. 2003;34:2835.)
© 2003 American Heart Association, Inc.

Original Contributions

Elevation of CRABP-I in the Cerebrospinal Fluid of Patients With Moyamoya Disease

Seung-Ki Kim, MD, PhD; Jong-Il Yoo, BS; Byung-Kyu Cho, MD, PhD; Soo Jin Hong, MS; Yong-Kook Kim, MS; Jung-Ae Moon, BS; Ji Ha Kim, MD; You-Nam Chung, MD Kyu-Chang Wang, MD, PhD

From the Division of Pediatric Neurosurgery and Laboratory for Fetal Medicine Research in Clinical Research Institute, Seoul National University Hospital, and Neuroscience Research Institute, Seoul National University Medical Research Center (S-K.K., B-K.C., S.J.H., J.H.K., Y-N.C., K-C.W.); and In2Gen Company (J-I.Y., Y-K.K., J-A.M.), Seoul, Korea.

Correspondence to Kyu-Chang Wang, MD, PhD, Division of Pediatric Neurosurgery, Seoul National University Children’s Hospital, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea. E-mail kcwang{at}snu.ac.kr

Background and Purpose— The etiology of moyamoya disease (MMD) remains obscure. This study was undertaken to identify specific proteins associated with the pathogenesis of MMD.

Methods— We studied cerebrospinal fluid (CSF) from 20 patients with angiographically confirmed MMD (4 boys and 16 girls; age range, 3 to 13 years; mean, 7.5 years) and 4 control patients with cerebral palsy who underwent selective dorsal rhizotomy (2 boys and 2 girls; age range, 5 to 10 years; mean, 7.3 years). CSF proteins were analyzed by 2-dimensional polyacrylamide gel electrophoresis, and protein identification was performed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The presence of specific CSF protein in patients with MMD was confirmed by Western blotting. In addition, cerebral CSF was also tested in 7 patients who had other brain diseases but no MMD (2 boys and 5 girls; age range, 1 to 12 years; mean, 6.9 years).

Results— We identified 1 polypeptide spot (M_r of 13 to 15 kDa and isoelectric point of 5 to 5.5) that was differentially expressed in the CSF samples of MMD patients (mean optical density intensity, 0.36±0.24; range, 0.05 to 0.92) and control spinal CSF samples (mean, 0.03±0.04; range, 0 to 0.08; P=0.002). This polypeptide was identified as cellular retinoic acid–binding protein (CRABP)-I. High levels of expression of CRABP-I in the CSF from 17 MMD children were confirmed by Western blotting.

Conclusions— The analysis of the CSF of MMD patients reveals high CRABP-I expression. The present study suggests that the elevation of CRABP-I in CSF may be a candidate for pathogenesis of MMD.

Key Words: cerebrospinal fluid • electrophoresis, gel, two-dimensional • moyamoya disease • protein binding • receptors, retinoic acid • spectrometry, mass, matrix-assisted laser desorption-ionization

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