Soluble brain proteins in dialysis encephalopathy

Permeability of the blood-brain barrier to neuropeptides: the case for penetration

Evidence that peptides can cross the blood-brain barrier (BBB) is reviewed. Penetration is suggested by the observations that blood levels correlate with cerebrospinal fluid levels for many peptides and that peripheral administration of peptides results in effects on the CNS. Passage is confirmed by experiments involving administration of a peptide (immunoactive or radioactive) in one compartment and identification of its appearance in the other, supported by such methods as selective labeling, cross-reactivity with highly specific antibodies, and chromatography. The degree of passage varies among peptides and their analogs. The major route of passage is probably by a non-competitive, non-saturable mechanism, wih the physicochemical characteristics of the peptide (e.g. lipophilicity, charge, molecular weight, and protein binding) determining the degree of passage. A competitive transport mechanism also exists for some peptides. Penetration of the BBB via large pores or by pinocytosis does not appear to be of major importance for peptides. Permeability of the BBB to peptides, but not to the larger iodinated albumin, is affected by intraperitoneal administration of aluminum, apparently by an increase in the permeability of the membrane to lipophilic materials.

The aluminum-induced increase in blood-brain barrier permeability to delta-sleep-inducing peptide occurs throughout the brain and is independent of phosphorus and acetylcholinesterase levels

The effect of aluminum on levels of inorganic phosphorus and acetylcholinesterase in blood and brain and on permeability of the blood-brain barrier (BBB) in different regions of the brain to the neuropeptide delta-sleep-inducing peptide (DSIP) was studied in adult rats. Aluminum (100 mg/kg) significantly increased the permeability of the BBB to intracarotid 125I-N-Tyr-DSIP so that levels of radioactivity in whole brain were 45% higher than in control animals. The pattern of regional distribution of radioactivity in the brain was, however, unaffected, demonstrating that the affect of aluminum occurs throughout the BBB. Aluminum also significantly decreased inorganic phosphorus levels in the serum by 19%, but this effect did not correlate with BBB permeability to DSIP. Aluminum did not decrease brain levels of phosphorus despite the drop in blood levels of phosphorus nor affect brain or blood levels of acetylcholinesterase. Experiments with radioactive 32P reinforced the finding that blood but not brain levels of phosphorus are reliably affected by aluminum. The lack of correlation between changes in BBB permeability and decreased levels of inorganic phosphorus in the blood suggests that the effect of aluminum may not be mediated by its effects on phosphorus metabolism. Also, the change in BBB permeability after administration of aluminum does not appear to depend on changes in brain cholinergic activity but does occur throughout the brain.

Pattern-reversal visual evoked potentials in patients with chronic renal insufficiency

Visual evoked potentials (VEPs) were recorded from 88 patients with chronic renal insufficiency twice at a 6 month interval. In dialysed patients statistically significant decreases in amplitudes and prolongations of VEP peak latencies were found. Azotaemic non-dialysed patients showed related, but smaller, changes in their VEPs. In patients after kidney transplantation the VEP amplitudes were normal but peak latencies were prolonged. No systematic significant relationship between the VEPs and creatinine and urea levels in the blood could be shown.