Skip to main content
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1998 May;64(5):643–647. doi: 10.1136/jnnp.64.5.643

Protein adsorption to hydrocephalus shunt catheters: CSF protein adsorption

H Brydon 1, G Keir 1, E Thompson 1, R Bayston 1, R Hayward 1, W Harkness 1
PMCID: PMC2170097  PMID: 9598681

Abstract

OBJECTIVE—To assess the quantity and nature of the proteins that adsorb to hydrocephalus shunt catheters after implantation, and to determine whether sufficient could accumulate to obstruct the catheter.
DESIGN—Elution of proteins from 102 explanted shunt catheters, with protein assay and electrophoresis of the eluate, and scanning electron microscopy (SEM) of the catheters.
RESULTS—The amount of protein elutable was extremely low, and significant protein, apart from a thin film, was not found on SEM. Qualitative analysis disclosed that most of the adsorbed protein was albumin.
CONCLUSIONS—Protein deposition on hydrocephalus catheters does not occur in sufficient quantities to cause catheter obstruction.



Full Text

The Full Text of this article is available as a PDF (171.3 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adegbite A. B., Khan M. Role of protein content in CSF ascites following ventriculoperitoneal shunting. Case report. J Neurosurg. 1982 Sep;57(3):423–425. doi: 10.3171/jns.1982.57.3.0423. [DOI] [PubMed] [Google Scholar]
  2. Anderson J. M., Bonfield T. L., Ziats N. P. Protein adsorption and cellular adhesion and activation on biomedical polymers. Int J Artif Organs. 1990 Jun;13(6):375–382. [PubMed] [Google Scholar]
  3. Anderson M., Matthews K. B., Stuart J. Coagulation and fibrinolytic activity of cerebrospinal fluid. J Clin Pathol. 1978 May;31(5):488–492. doi: 10.1136/jcp.31.5.488. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bayston R. A model of catheter colonisation in vitro and its relationship to clinical catheter infections. J Infect. 1984 Nov;9(3):271–276. doi: 10.1016/s0163-4453(84)90596-6. [DOI] [PubMed] [Google Scholar]
  5. Bayston R., Leung T. S., Wilkins B. M., Hodges B. Bacteriological examination of removed cerebrospinal fluid shunts. J Clin Pathol. 1983 Sep;36(9):987–990. doi: 10.1136/jcp.36.9.987. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Bayston R., Penny S. R. Excessive production of mucoid substance in staphylococcus SIIA: a possible factor in colonisation of Holter shunts. Dev Med Child Neurol Suppl. 1972;27:25–28. doi: 10.1111/j.1469-8749.1972.tb09769.x. [DOI] [PubMed] [Google Scholar]
  7. Brydon H. L., Bayston R., Hayward R., Harkness W. Reduced bacterial adhesion to hydrocephalus shunt catheters mediated by cerebrospinal fluid proteins. J Neurol Neurosurg Psychiatry. 1996 Jun;60(6):671–675. doi: 10.1136/jnnp.60.6.671. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Brydon H. L., Bayston R., Hayward R., Harkness W. Removed shunt valves: reasons for failure and implications for valve design. Br J Neurosurg. 1996 Jun;10(3):245–251. doi: 10.1080/02688699650040098. [DOI] [PubMed] [Google Scholar]
  9. Brydon H. L., Bayston R., Hayward R., Harkness W. The effect of protein and blood cells on the flow-pressure characteristics of shunts. Neurosurgery. 1996 Mar;38(3):498–505. doi: 10.1097/00006123-199603000-00016. [DOI] [PubMed] [Google Scholar]
  10. Brydon H. L., Hayward R., Harkness W., Bayston R. Does the cerebrospinal fluid protein concentration increase the risk of shunt complications? Br J Neurosurg. 1996 Jun;10(3):267–273. doi: 10.1080/02688699650040124. [DOI] [PubMed] [Google Scholar]
  11. Brydon H. L., Hayward R., Harkness W., Bayston R. Physical properties of cerebrospinal fluid of relevance to shunt function. 1: The effect of protein upon CSF viscosity. Br J Neurosurg. 1995;9(5):639–644. doi: 10.1080/02688699550040927. [DOI] [PubMed] [Google Scholar]
  12. Brydon H. L., Hayward R., Harkness W., Bayston R. Physical properties of cerebrospinal fluid of relevance to shunt function. 2: The effect of protein upon CSF surface tension and contact angle. Br J Neurosurg. 1995;9(5):645–651. doi: 10.1080/02688699550040936. [DOI] [PubMed] [Google Scholar]
  13. Cottonaro C. N., Roohk H. V., Shimizu G., Sperling D. R. Quantitation and characterization of competitive protein binding to polymers. Trans Am Soc Artif Intern Organs. 1981;27:391–395. [PubMed] [Google Scholar]
  14. Dube R. K., Sahaa P. K., Dube B., Katiyar B. C., Rao P. V. Fibrinogen, fibrinogen degradation products and fibrinolytic activity in cerebrospinal fluid in stroke. Indian J Med Res. 1980 Sep;72:454–457. [PubMed] [Google Scholar]
  15. Espersen F., Wilkinson B. J., Gahrn-Hansen B., Thamdrup Rosdahl V., Clemmensen I. Attachment of staphylococci to silicone catheters in vitro. APMIS. 1990 May;98(5):471–478. [PubMed] [Google Scholar]
  16. Hakim S. Observations on the physiopathology of the CSF pulse and prevention of ventricular catheter obstruction in valve shunts. Dev Med Child Neurol Suppl. 1969;20:42–48. doi: 10.1111/j.1469-8749.1969.tb09243.x. [DOI] [PubMed] [Google Scholar]
  17. Herrmann M., Vaudaux P. E., Pittet D., Auckenthaler R., Lew P. D., Schumacher-Perdreau F., Peters G., Waldvogel F. A. Fibronectin, fibrinogen, and laminin act as mediators of adherence of clinical staphylococcal isolates to foreign material. J Infect Dis. 1988 Oct;158(4):693–701. doi: 10.1093/infdis/158.4.693. [DOI] [PubMed] [Google Scholar]
  18. Jeppsson J. O., Laurell C. B., Franzén B. Agarose gel electrophoresis. Clin Chem. 1979 Apr;25(4):629–638. [PubMed] [Google Scholar]
  19. Keir G., Thompson E. J. Ultrasensitive staining for proteins after agarose electrophoresis of unconcentrated cerebrospinal fluid. Ann Clin Biochem. 1988 Jan;25(Pt 1):116–117. doi: 10.1177/000456328802500119. [DOI] [PubMed] [Google Scholar]
  20. Kossovsky N., Snow R. B. Clinical-pathological analysis of failed central nervous system fluid shunts. J Biomed Mater Res. 1989 Apr;23(A1):73–86. doi: 10.1002/jbm.820231308. [DOI] [PubMed] [Google Scholar]
  21. Limber G. K., Glenn C. H., Mason R. G. Studies of the proteins elutable from certain artificial surfaces exposed to human plasma. Thromb Res. 1974 Dec;5(6):735–746. doi: 10.1016/0049-3848(74)90117-0. [DOI] [PubMed] [Google Scholar]
  22. Little J. R., Rhoton A. L., Jr, Mellinger J. F. Comparison of ventriculoperitoneal and ventriculoatrial shunts for hydrocephalus in children. Mayo Clin Proc. 1972 Jun;47(6):396–401. [PubMed] [Google Scholar]
  23. Luxton R. W., Patel P., Keir G., Thompson E. J. A micro-method for measuring total protein in cerebrospinal fluid by using benzethonium chloride in microtiter plate wells. Clin Chem. 1989 Aug;35(8):1731–1734. [PubMed] [Google Scholar]
  24. Lyman D. J., Metcalf L. C., Albo D., Jr, Richards K. F., Lamb J. The effect of chemical structure and surface properties of synthetic polymers on the coagulation of blood. III. In vivo adsorption of proteins on polymer surfaces. Trans Am Soc Artif Intern Organs. 1974;20 B:474–478. [PubMed] [Google Scholar]
  25. Puca A., Anile C., Maira G., Rossi G. Cerebrospinal fluid shunting for hydrocephalus in the adult: factors related to shunt revision. Neurosurgery. 1991 Dec;29(6):822–826. doi: 10.1097/00006123-199112000-00003. [DOI] [PubMed] [Google Scholar]
  26. Salmon J. H. A ventriculo-peritoneal shunt for hemorrhagic or high protein fluid. Surg Neurol. 1977 Jul;8(1):69–70. [PubMed] [Google Scholar]
  27. Schachter P., Findler G. Continuous spinal drainage of high viscosity C.S.F. using IVAC system--technical note. Acta Neurochir (Wien) 1987;84(1-2):71–72. doi: 10.1007/BF01456355. [DOI] [PubMed] [Google Scholar]
  28. Sekhar L. N., Moossy J., Guthkelch A. N. Malfunctioning ventriculoperitoneal shunts. Clinical and pathological features. J Neurosurg. 1982 Mar;56(3):411–416. doi: 10.3171/jns.1982.56.3.0411. [DOI] [PubMed] [Google Scholar]
  29. Snow R. B., Kossovsky N. Hypersensitivity reaction associated with sterile ventriculoperitoneal shunt malfunction. Surg Neurol. 1989 Mar;31(3):209–214. doi: 10.1016/0090-3019(89)90119-5. [DOI] [PubMed] [Google Scholar]
  30. Towbin H., Staehelin T., Gordon J. Electrophoretic transfer of proteins from polyacrylamide gels to nitrocellulose sheets: procedure and some applications. Proc Natl Acad Sci U S A. 1979 Sep;76(9):4350–4354. doi: 10.1073/pnas.76.9.4350. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Vaudaux P. E., Waldvogel F. A., Morgenthaler J. J., Nydegger U. E. Adsorption of fibronectin onto polymethylmethacrylate and promotion of Staphylococcus aureus adherence. Infect Immun. 1984 Sep;45(3):768–774. doi: 10.1128/iai.45.3.768-774.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Vaudaux P., Suzuki R., Waldvogel F. A., Morgenthaler J. J., Nydegger U. E. Foreign body infection: role of fibronectin as a ligand for the adherence of Staphylococcus aureus. J Infect Dis. 1984 Oct;150(4):546–553. doi: 10.1093/infdis/150.4.546. [DOI] [PubMed] [Google Scholar]
  33. Weathersby P. K., Horbett T. A., Hoffman A. S. A new method for analysis of the adsorbed plasma protein layer on biomaterial surfaces. Trans Am Soc Artif Intern Organs. 1976;22:242–252. [PubMed] [Google Scholar]
  34. Yount R. A., Glazier M. C., Mealey J., Jr, Kalsbeck J. E. Cerebrospinal fluid ascites complicating ventriculoperitoneal shunting. Report of four cases. J Neurosurg. 1984 Jul;61(1):180–183. doi: 10.3171/jns.1984.61.1.0180. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES