Fingerprint changes in CSF composition associated with different aetiologies in human neonatal hydrocephalus: Inflammatory cytokines

Irum Naureen, Kh A Irfan Waheed, Ahsen W. Rathore, Suresh Victor, Conor Mallucci, John R. Goodden, Shahid N. Chohan, Jaleel A. Miyan

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Purpose: Hydrocephalus (HC) has a multifactorial and complex picture of pathophysiology due to aetiology, age at and duration since onset. We have previously identified distinctions in markers of cell death associated with different aetiologies. Here, we examined cerebrospinal fluid (CSF) from human HC neonates for cytokines to identify further distinguishing features of different aetiologies. Methods: CSF was collected during routine lumbar puncture or ventricular tap from neonates with hydrocephalus, or with no neurological condition (normal controls). Total protein, Fas receptor, Fas ligand, stem cell factor (SCF), hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), insulin growth factor-1 (IGF-1), tumour necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) were measured and compared between 8 unaffected and 28 HC neonatal CSF samples. Results: Total protein was significantly (P <0.05) raised in late-onset hydrocephalus (LOH). Fas receptor was raised (P <0.05) in post-haemorrhagic hydrocephalus (PHH) and spina bifida with hydrocephalus (SB/HC), but no difference in Fas ligand was found. SCF was raised (P <0.05) in SB/HC. HGF was found in all HC and was increased (P <0.01) in PHH. Increased VEGF was found in PHH (P <0.01) and SB/HC (P <0.05). Variable levels of IL-6, TNF-α and IGF-1 were found in all HC groups compared with none in normal. Conclusions: LOH was unusual with significantly raised total protein indicating an inflammatory state. Increased Fas receptor, VEGF, IGF-1 and HGF suggest anti-apoptotic and repair mechanism activation. By contrast, elevated TNF-α and IL-6 indicate inflammatory processes in these neonatal brains. Taken with our previous study, these data indicate that different pathophysiology, inflammation and repair are occurring in HC of different aetiologies and that additional treatment strategies may benefit these infants in addition to fluid diversion. © 2014 Springer-Verlag.
    Original languageEnglish
    Pages (from-to)1155-1164
    Number of pages9
    JournalChild's Nervous System
    Volume30
    Issue number7
    DOIs
    Publication statusPublished - 2014

    Keywords

    • Aetiology
    • CSF
    • Cytokines
    • Fetus
    • Human
    • Hydrocephalus
    • Inflammation
    • Neonate

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