Molecular Insights to explore the role of Blood and CSF Biomarkers in the Pathophysiology of Idiopathic Intracranial Hypertension (IIH)
Vaishali Sharma1, Kamalesh Chakravarty1, Sucharita Ray1, Pramod Avti2
1Department of Neurology, 2Department of Biophysics, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh-India
Objective:
To assess the Biomarkers for Neuroinflammation and Blood-brain-barrier disruption (Aquaporin, Renin-angiotensin and Heat shock proteins) in Blood and cerebrospinal fluid(CSF) of patients with Idiopathic Intracranial Hypertension(IIH).
Background:
IIH is a neurological disease characterized by high CSF-pressure without any defined pathogenesis. Blood-brain-barrier disruption and neuroinflammation are considered to be involved in IIH but currently there is not much evidence. Establishing the biomarkers for these such as Aquaporin-1, Aquaporin-4, Renin-Angiotensin, Heat shock proteins and CD-146 may offer valuable prognostic insights and therapeutic implication.
Design/Methods:
Forty IIH patients diagnosed as per Friedman’s-Criteria along with forty age and sex-matched individuals undergoing spinal-anesthesia for non-neurological elective surgery and forty healthy controls were enrolled in this study from March 2023 to September 2024 in a tertiary care Centre from North India. Headache assessment was done using MIDAS and HIT6 scale. Biomarkers were quantified using ELISA and RT-PCR technique.
Results:
Mean age of cases was 35.73(9.75), and BMI 28.15(5.16). Aquaporin-4 levels in CSF were reduced in IIH patients (p=0.016). Renin levels were elevated in the CSF of IIH patients (p=0.008), Aquaporin-1 and Angiotensin levels were not significantly altered. HSP70 gene expression in Blood was higher in IIH patients (p=0.002). HSP60 and CD146 gene expression was higher in the CSF of IIH patients (p=0.038, p=0.008). BMI was positively correlated with serum Aquaporin-4 (r= 0.259) and CSF HSP60 (r=402). MIDAS-scores had significant positive correlation with CSF HSP70 (r=0.406), Blood HSP60 (r=0.339), and HIT6-Score had significant positive correlation with CSF HSP70 (r=0.392), Blood CD146 (r=0.346).
Conclusions:
The study highlights a significant reduction in in the levels of CSF Aquaporin-4 and an increase in levels of CSF Renin in IIH patients along with altered gene expression levels of HSP60, HSP70, and CD146 in blood and CSF suggesting their role in pathophysiology. Establishing these markers can help in potential therapeutic targets or diagnostic tools for IIH.
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