ing in a glial neoplasm (
anaplastic astrocytoma) ing of an astrocyte in cell culture in red and counterstained for
vimentin in green. GFAP and vimentin colocalize in cytoplasmic
intermediate filaments, so the astrocyte appears yellow. Nuclear DNA is stained blue with
DAPI. Antibodies, cell preparation and image generated by
EnCor Biotechnology Inc. There are multiple disorders associated with improper GFAP regulation, and injury can cause
glial cells to react in detrimental ways.
Glial scarring is a consequence of several
neurodegenerative conditions, as well as injury that severs neural material. The scar is formed by
astrocytes interacting with
fibrous tissue to re-establish the glial margins around the central injury core and is partially caused by
up-regulation of GFAP. Another condition directly related to GFAP is
Alexander disease, a rare genetic disorder. Its symptoms include mental and physical retardation,
dementia, enlargement of the brain and head,
spasticity (stiffness of arms and/or legs), and
seizures. The cellular mechanism of the disease is the presence of
cytoplasmic accumulations containing GFAP and
heat shock proteins, known as
Rosenthal fibers. Mutations in the
coding region of GFAP have been shown to contribute to the accumulation of Rosenthal fibers. Some of these mutations have been proposed to be detrimental to
cytoskeleton formation as well as an increase in
caspase 3 activity, which would lead to increased
apoptosis of cells with these mutations. GFAP therefore plays an important role in the pathogenesis of Alexander disease. Notably, the expression of some GFAP
isoforms have been reported to decrease in response to
acute infection or
neurodegeneration. The
HIV-1 viral envelope glycoprotein gp120 can directly inhibit the
phosphorylation of GFAP and GFAP levels can be decreased in response to
chronic infection with HIV-1,
varicella zoster, and
pseudorabies. Decreases in GFAP expression have been reported in
Down's syndrome,
schizophrenia,
bipolar disorder and
depression. The generally high abundance of GFAP in the
CNS has led to a great interest in GFAP as a blood
biomarker of acute injury to the brain and spinal cord in different types of disease mechanisms, such as
traumatic brain injury and
cerebrovascular disease. After an ischemic stroke, blood levels of GFAP peak after three days and correlates strongly with infarct volume. Elevated blood levels of GFAP are also found in neuroinflammatory diseases, such as
multiple sclerosis and
neuromyelitis optica, a disease targeting astrocytes.
Autoimmune astrocytopathy In 2016 a CNS inflammatory disorder associated with anti-GFAP
antibodies was described. Patients with
autoimmune GFAP astrocytopathy developed meningoencephalomyelitis with inflammation of the
meninges, the brain
parenchyma, and the
spinal cord. About one third of cases were associated with various
cancers and many also expressed other CNS
autoantibodies.
Meningoencephalitis is the predominant clinical presentation of autoimmune GFAP astrocytopathy in published case series. It also can appear associated with
encephalomyelitis and
parkinsonism. == Isoforms ==