Arabinitol enantiomers in cerebrospinal fluid

d-Arabinitol is a metabolite of Candida species, and its presence in serum above endogenous concentration may indicate disseminated candidiasis. The o-trifluoroacetylated derivatives of arabinitol enantiomers in cerebrospinal fluid (CSF) were separated using perpentylated cyclodextrin capillary columns and measured by selected ion monitoring using negative chemical ionization mass spectrometry. The presence of d-arabinitol was confirmed using highly specific d-arabinitol dehydrogenase. The mean d l-arabinitol ratio, 16.7 ± 4.8 (range: 8.6-22.8), in CSF of the "controls" is approximately 10-fold higher than the ratio previously found in normal serum and urine. At the same time, the mean l-arabinitol concentration, 0.13 ± 0.05 (range: 0.09-0.2), is virtually identical to that in serum. Therefore, the high d l-arabinitol ratio in CSF is attributed to d-arabinitol. Persistently high d l ratios were found in a variety of diseases (without Candida infection). The finding of d-arabinitol in CSF suggests that serum d-arabinitol may originate from the brain or the spinal cord, rather than from resident Candida species in the gut, and that the accumulation of d-arabinitol in CSF may be caused by non-consumption or, conversely, the high concentration may be maintained in order to have it readily available for metabolism in the brain.