Quantification of Bile Acids in Cerebrospinal Fluid: Results of an Observational Trial
(1) Background: Bile acids, known as aids in intestinal fat digestion and as messenger molecules in serum, can be detected in cerebrospinal fluid (CSF), although the blood–brain barrier is generally an insurmountable obstacle for bile acids. The exact mechanisms of the occurrence, as well as possibl...
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| Format: | Article |
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MDPI AG
2023-11-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/11/11/2947 |
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| author | Lars-Olav Harnisch Sophie Neugebauer Diana Mihaylov Abass Eidizadeh Bozena Zechmeister Ilko Maier Onnen Moerer |
| author_facet | Lars-Olav Harnisch Sophie Neugebauer Diana Mihaylov Abass Eidizadeh Bozena Zechmeister Ilko Maier Onnen Moerer |
| author_sort | Lars-Olav Harnisch |
| collection | DOAJ |
| description | (1) Background: Bile acids, known as aids in intestinal fat digestion and as messenger molecules in serum, can be detected in cerebrospinal fluid (CSF), although the blood–brain barrier is generally an insurmountable obstacle for bile acids. The exact mechanisms of the occurrence, as well as possible functions of bile acids in the central nervous system, are not precisely understood. (2) Methods: We conducted a single-center observational trial. The concentrations of 15 individual bile acids were determined using an in-house LC-MS/MS method in 54 patients with various acute and severe disorders of the central nervous system. We analyzed CSF from ventricular drainage taken within 24 h after placement, and blood samples were drawn at the same time for the presence and quantifiability of 15 individual bile acids. (3) Results: At a median time of 19.75 h after a cerebral insult, the concentration of bile acids in the CSF was minute and almost negligible. The CSF concentrations of total bile acids (TBAs) were significantly lower compared to the serum concentrations (serum 0.37 µmol/L [0.24, 0.89] vs. 0.14 µmol/L [0.05, 0.43]; <i>p</i> = 0.033). The ratio of serum-to-CSF bile acid levels calculated from the respective total concentrations were 3.10 [0.94, 14.64] for total bile acids, 3.05 for taurocholic acid, 14.30 [1.11, 27.13] for glycocholic acid, 0.0 for chenodeoxycholic acid, 2.19 for taurochenodeoxycholic acid, 1.91 [0.68, 8.64] for glycochenodeoxycholic acid and 0.77 [0.0, 13.79] for deoxycholic acid; other bile acids were not detected in the CSF. The ratio of CSF-to-serum S100 concentration was 0.01 [0.0, 0.02]. Serum total and conjugated (but not unconjugated) bilirubin levels and serum TBA levels were significantly correlated (total bilirubin <i>p</i> = 0.031 [0.023, 0.579]; conjugated bilirubin <i>p</i> = 0.001 [0.193, 0.683]; unconjugated <i>p</i> = 0.387 [−0.181, 0.426]). No correlations were found between bile acid concentrations and age, delirium, intraventricular blood volume, or outcome measured on a modified Rankin scale. (4) Conclusions: The determination of individual bile acids is feasible using the current LC-MS/MS method. The results suggest an intact blood–brain barrier in the patients studied. However, bile acids were detected in the CSF, which could have been achieved by active transport across the blood–brain barrier. |
| first_indexed | 2024-03-09T17:00:45Z |
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| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-09T17:00:45Z |
| publishDate | 2023-11-01 |
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| spelling | doaj.art-8d37d2bfd00e4cf09b48ed6b95a1ecbb2023-11-24T14:30:53ZengMDPI AGBiomedicines2227-90592023-11-011111294710.3390/biomedicines11112947Quantification of Bile Acids in Cerebrospinal Fluid: Results of an Observational TrialLars-Olav Harnisch0Sophie Neugebauer1Diana Mihaylov2Abass Eidizadeh3Bozena Zechmeister4Ilko Maier5Onnen Moerer6Department of Anaesthesiology, University Medical Center, University of Göttingen, Robert-Koch-Str. 40, D-37075 Göttingen, GermanyInstitute of Clinical Chemistry and Laboratory Diagnostics, University Hospital Jena, Am Klinikum 1, D-07747 Jena, GermanyInstitute of Clinical Chemistry and Laboratory Diagnostics, University Hospital Jena, Am Klinikum 1, D-07747 Jena, GermanyInterdisciplinary UMG Laboratories, University Medical Center, University of Göttingen, Robert-Koch-Str. 40, D-37075 Göttingen, GermanyInterdisciplinary UMG Laboratories, University Medical Center, University of Göttingen, Robert-Koch-Str. 40, D-37075 Göttingen, GermanyDepartment of Neurology, University Medical Center, University of Göttingen, Robert-Koch-Str. 40, D-37075 Göttingen, GermanyDepartment of Anaesthesiology, University Medical Center, University of Göttingen, Robert-Koch-Str. 40, D-37075 Göttingen, Germany(1) Background: Bile acids, known as aids in intestinal fat digestion and as messenger molecules in serum, can be detected in cerebrospinal fluid (CSF), although the blood–brain barrier is generally an insurmountable obstacle for bile acids. The exact mechanisms of the occurrence, as well as possible functions of bile acids in the central nervous system, are not precisely understood. (2) Methods: We conducted a single-center observational trial. The concentrations of 15 individual bile acids were determined using an in-house LC-MS/MS method in 54 patients with various acute and severe disorders of the central nervous system. We analyzed CSF from ventricular drainage taken within 24 h after placement, and blood samples were drawn at the same time for the presence and quantifiability of 15 individual bile acids. (3) Results: At a median time of 19.75 h after a cerebral insult, the concentration of bile acids in the CSF was minute and almost negligible. The CSF concentrations of total bile acids (TBAs) were significantly lower compared to the serum concentrations (serum 0.37 µmol/L [0.24, 0.89] vs. 0.14 µmol/L [0.05, 0.43]; <i>p</i> = 0.033). The ratio of serum-to-CSF bile acid levels calculated from the respective total concentrations were 3.10 [0.94, 14.64] for total bile acids, 3.05 for taurocholic acid, 14.30 [1.11, 27.13] for glycocholic acid, 0.0 for chenodeoxycholic acid, 2.19 for taurochenodeoxycholic acid, 1.91 [0.68, 8.64] for glycochenodeoxycholic acid and 0.77 [0.0, 13.79] for deoxycholic acid; other bile acids were not detected in the CSF. The ratio of CSF-to-serum S100 concentration was 0.01 [0.0, 0.02]. Serum total and conjugated (but not unconjugated) bilirubin levels and serum TBA levels were significantly correlated (total bilirubin <i>p</i> = 0.031 [0.023, 0.579]; conjugated bilirubin <i>p</i> = 0.001 [0.193, 0.683]; unconjugated <i>p</i> = 0.387 [−0.181, 0.426]). No correlations were found between bile acid concentrations and age, delirium, intraventricular blood volume, or outcome measured on a modified Rankin scale. (4) Conclusions: The determination of individual bile acids is feasible using the current LC-MS/MS method. The results suggest an intact blood–brain barrier in the patients studied. However, bile acids were detected in the CSF, which could have been achieved by active transport across the blood–brain barrier.https://www.mdpi.com/2227-9059/11/11/2947bile acidsblood–brain barrieradaptive responseactive transport |
| spellingShingle | Lars-Olav Harnisch Sophie Neugebauer Diana Mihaylov Abass Eidizadeh Bozena Zechmeister Ilko Maier Onnen Moerer Quantification of Bile Acids in Cerebrospinal Fluid: Results of an Observational Trial Biomedicines bile acids blood–brain barrier adaptive response active transport |
| title | Quantification of Bile Acids in Cerebrospinal Fluid: Results of an Observational Trial |
| title_full | Quantification of Bile Acids in Cerebrospinal Fluid: Results of an Observational Trial |
| title_fullStr | Quantification of Bile Acids in Cerebrospinal Fluid: Results of an Observational Trial |
| title_full_unstemmed | Quantification of Bile Acids in Cerebrospinal Fluid: Results of an Observational Trial |
| title_short | Quantification of Bile Acids in Cerebrospinal Fluid: Results of an Observational Trial |
| title_sort | quantification of bile acids in cerebrospinal fluid results of an observational trial |
| topic | bile acids blood–brain barrier adaptive response active transport |
| url | https://www.mdpi.com/2227-9059/11/11/2947 |
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