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Substance P in human cerebrospinal fluid

Reductions in peripheral neuropathy and autonomic dysfunction

From the Experimental Therapeutics Branch (Drs. Nutt, Williams, Engel, and Chase), National Institute of Neurological and Communicative Disorders and Stroke, Bethesda, MD, and the Laboratory of Human Reproduction and Reproductive Biology and the Department of Physiology, Harvard Medical School (Drs. Mroz and Leeman), Boston, MA.

Substance P (SP), a putative peptide neurotransmitter, was measured in human lumbar cerebrospinal fluid (CSF) by radioimmunoassay. Substance P-like immunoreactivity (SPLI) was present in the CSF of 18 neurologically normal adults in concentrations ranging from 2.9 to 11.1 fmol per milliliter, with a mean of 7.0 ± 0.6 fmol per milliliter (mean ± SE). Slightly more than half of the CSF-SPLI cochromatographed with synthetic SP on Sephadex G-25. There was no apparent gradient in CSF-SPLI concentration over the first 30 ml of CSF removed by lumbar puncture. Mean concentrations of CSF-SPLI in patients with Huntington disease, parkinsonism, miscellaneous dyskinesias, progressive supranuclear palsy, myopathy, and amyotrophic lateral sclerosis did not differ significantly from normal. Patients with neuropathy or multiple-system atrophy (Shy-Drager syndrome) had significantly reduced mean CSF-SPLI concentrations. These observations suggest that lumbar CSF-SPLI arises largely from spinal cord, nerve roots, or dorsal root ganglia, and that pathologic processes affecting these structures may be reflected by reduced levels of CSF-SPLI.

Address correspondence and reprint requests to Dr. Nutt, University of Oregon Health Sciences Center, Department of Neurology, 3181 Southwest Sam Jackson Park Road, Portland, OR 97201.

Accepted for publication January 31, 1980.

Presented in part at the thirtieth annual meeting of the American Academy of Neurology, Los Angeles, CA, April 1978.

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