Cholesterol esterase activity in cerebrospinal fluid of multiple sclerosis patients

Previous studies of brain tissue from multiple sclerosis (MS) patients have shown that the amount of cholesterol esters increases and the level of cholesterol esterase (ChE) activity decreases compared to controls. In this study we present a simple method for measuring ChE activity at pH 7.2 in cerebrospinal fluid (CSF) and CSF-ChE activity during the 18-month follow-up of 32 MS patients in remitting, remitting and relapsing, and chronic progressive courses of the disease. ChE activity in the MS group was compared to the enzyme activity in the CSF of 52 controls and 17 patients suffering from other organic neurological diseases. In the relapse group, ChE activity decreased significantly compared to the chronic progressive group (P less than 0.05) and controls (P less than 0.001). ChE activity was correlated with the Kurtzke points of functional status only in the chronic progressive group of MS patients (P less than 0.05, r = 0.569). During the 18-month follow-up, no significant change was seen in individual levels of ChE among the MS patients. It was concluded that the decrease in pH 7.2 ChE activity in the CSF during the acute phase of MS may reflect the decreased ChE activity in the brains of MS patients. However, the large interindividual variation within patient groups and the slow change at different stages of the disease indicate that measurement of ChE activity in CSF is not suitable for evaluating the clinical diagnosis of MS or for follow-up of the activity of the disease.