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000286093 1001_ $$0P:(DE-2719)9002026$$aHalbgebauer, Steffen$$b0$$udzne
000286093 245__ $$aDistinct cerebrospinal fluid profiles of astrocytic aquaporin-4 and GFAP in neuroinflammatory disorders.
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000286093 520__ $$aAquaporin 4 (AQP4), a water channel expressed in astrocytic end feet forming the blood brain barrier, is predominantly expressed in the central nervous system. Cerebrospinal fluid (CSF) AQP4 has now been suggested as a possible fluid biomarker in Alzheimer's disease. However, its diagnostic potential in primary neuroinflammatory diseases, where also AQP4 autoantibodies can circulate, has so far not been studied. We investigated the CSF of 301 patients for AQP4 and GFAP using ELISA. The single-center cohort consisted of patients with multiple sclerosis (n = 81), chronic inflammatory demyelinating polyneuropathy (n = 23), Guillain-Barré-Syndrome (n = 13), meningitis/ encephalitis (Men/Enc) (n = 19), myelin oligodendrocyte glycoprotein antibody disease (n = 6), neuromyelitis optica spectrum disease (NMOSD) (n = 12), and non-immune mediated polyneuropathy (NIP) patients (n = 49). 98 patients without acute or chronic neuroinflammation and neurodegneration served as controls. Both CSF AQP4 (r = 0.45 (95%CI: 0.36-0.54), p < 0.0001) and GFAP (r = 0.4 (95%CI: 0.30-0.49), p < 0.0001) correlated with age in the whole cohort. CSF AQP4 levels were elevated in the NIP group compared to control, MS and Men/Enc patients (p = 0.002, p = 0.029 and 0.005, respectively). When stratified further, the hereditary NIP patients (n = 26) displayed the highest AQP4 levels of all groups. CSF GFAP was elevated in the AQP4 autoantibody positive NMOSD group but was not increased in AQP4 autoantibody negative NMOSD patients. CSF AQP4 levels were similar in both NMOSD groups. Combining AQP4 and GFAP levels or calculating their ratio did not prominently enhance diagnostic discrimination. The study highlights the diagnostic potential of AQP4 as a fluid biomarker in neurological conditions, especially in peripheral neuropathies, while confirming GFAP as marker for astrocytic injury in autoantibody positive NMOSD patients. Our findings suggest that AQP4 and GFAP reflect different astrocytic processes in neurological diseases.
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000286093 650_7 $$2Other$$aAquaporin 4
000286093 650_7 $$2Other$$aAstrocytes
000286093 650_7 $$2Other$$aBiomarker
000286093 650_7 $$2Other$$aCerebrospinal fluid
000286093 650_7 $$2Other$$aGFAP
000286093 650_7 $$2NLM Chemicals$$aAquaporin 4
000286093 650_7 $$2NLM Chemicals$$aAQP4 protein, human
000286093 650_7 $$2NLM Chemicals$$aBiomarkers
000286093 650_7 $$2NLM Chemicals$$aGlial Fibrillary Acidic Protein
000286093 650_7 $$2NLM Chemicals$$aGFAP protein, human
000286093 650_7 $$2NLM Chemicals$$aAutoantibodies
000286093 650_2 $$2MeSH$$aHumans
000286093 650_2 $$2MeSH$$aAquaporin 4: cerebrospinal fluid
000286093 650_2 $$2MeSH$$aMale
000286093 650_2 $$2MeSH$$aFemale
000286093 650_2 $$2MeSH$$aMiddle Aged
000286093 650_2 $$2MeSH$$aAdult
000286093 650_2 $$2MeSH$$aBiomarkers: cerebrospinal fluid
000286093 650_2 $$2MeSH$$aAstrocytes: metabolism
000286093 650_2 $$2MeSH$$aGlial Fibrillary Acidic Protein: cerebrospinal fluid
000286093 650_2 $$2MeSH$$aAged
000286093 650_2 $$2MeSH$$aNeuroinflammatory Diseases: cerebrospinal fluid
000286093 650_2 $$2MeSH$$aNeuroinflammatory Diseases: diagnosis
000286093 650_2 $$2MeSH$$aCohort Studies
000286093 650_2 $$2MeSH$$aYoung Adult
000286093 650_2 $$2MeSH$$aAutoantibodies: cerebrospinal fluid
000286093 7001_ $$aWinger, Niklas$$b1
000286093 7001_ $$aElmas, Zeynep$$b2
000286093 7001_ $$aFazeli, Badrieh$$b3
000286093 7001_ $$aBachhuber, Franziska$$b4
000286093 7001_ $$aErhart, Deborah K$$b5
000286093 7001_ $$aSoylu, Önder$$b6
000286093 7001_ $$0P:(DE-2719)9001969$$aKlassen, Paula$$b7$$udzne
000286093 7001_ $$aSenel, Makbule$$b8
000286093 7001_ $$0P:(DE-2719)9001951$$aDorst, Johannes$$b9$$udzne
000286093 7001_ $$aHaeusler, Karl Georg$$b10
000286093 7001_ $$0P:(DE-2719)9000455$$aWeishaupt, Jochen H$$b11
000286093 7001_ $$aOtto, Markus$$b12
000286093 7001_ $$0P:(DE-2719)9002007$$aTumani, Hayrettin$$b13$$udzne
000286093 773__ $$0PERI:(DE-600)1471408-5$$a10.1016/j.nbd.2026.107351$$gVol. 222, p. 107351 -$$p107351$$tNeurobiology of disease$$v222$$x0969-9961$$y2026
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