A comparison of blood and cerebrospinal fluid cytokines (IL-1β, IL-6, IL-18, TNF-α) in neonates with perinatal hypoxia

• Published in: Bosnian journal of basic medical sciences Vol. 17; no. 3; pp. 203 - 210
• Main Authors: Šumanović-Glamuzina, Darinka, Čulo, Filip, Čulo, Melanie Ivana, Konjevoda, Paško, Jerković-Raguž, Marjana
• Format: Journal Article
• Language: English
• Published: Bosnia and Herzegovina Association of Basic Medical Sciences 01-08-2017; Association of Basic Medical Sciences of Federation of Bosnia and Herzegovina
• Subjects: Asphyxia Neonatorum - blood; Asphyxia Neonatorum - cerebrospinal fluid; Asphyxia Neonatorum - complications; Brain; Cohort Studies; Complications and side effects; Cytokines - blood; Cytokines - cerebrospinal fluid; Diagnosis; Diseases; Female; Health aspects; Humans; Hypoxia; Hypoxia, Brain - blood; Hypoxia, Brain - cerebrospinal fluid; Hypoxia-Ischemia, Brain - blood; Hypoxia-Ischemia, Brain - cerebrospinal fluid; Hypoxia-Ischemia, Brain - complications; Infant, Newborn; Infants (Newborn); Injuries; Interleukin-18 - blood; Interleukin-18 - cerebrospinal fluid; Interleukin-1beta - blood; Interleukin-1beta - cerebrospinal fluid; Interleukin-6 - blood; Interleukin-6 - cerebrospinal fluid; Interleukins; Male; Measurement; Nervous System Diseases - etiology; Pediatric research; Pregnancy; Prospective Studies; Treatment Outcome; Tumor necrosis factor; Tumor Necrosis Factor-alpha - blood; Tumor Necrosis Factor-alpha - cerebrospinal fluid; Croatia
• ISSN: 1512-8601; 1840-4812
• DOI: 10.17305/bjbms.2017.1381

Perinatal hypoxia-ischemia is a specific and important pathological event in neonatal care practice. The data on relationship between the concentrations of cytokines in blood and cerebrospinal fluid (CSF) and perinatal brain injury are scarce. The aim of this study is to evaluate changes in interleukin (IL-1β, IL-6, and IL-18) and tumor necrosis factor alpha (TNF-α) levels in newborns with perinatal hypoxia (PNH). CSF and serum samples of 35 term and near-term (35-40 weeks) newborns with PNH, at the age of 3-96 hours, were analyzed using enzyme-linked immunosorbent assay. Control group consisted of 25 non-asphyxic/non-hypoxic infants of the same age sampled for clinically suspected perinatal meningitis, but proven negative and healthy otherwise. The cytokine values in CSF and serum samples were determined in relation to initial hypoxic-ischemic encephalopathy (HIE) staged according the Sarnat/Sarnat method, and compared with neurological outcome at 12 months of age estimated using Amiel-Tison procedure. The concentrations of IL-6 and TNF-α in serum of PNH patients were significantly higher compared to control group (p = 0.0407 and p = 0.023, respectively). No significant difference between average values of cytokines in relation to the stage of HIE was observed. Significantly higher levels of IL-6 and IL-18 corresponded to a mildly abnormal neurological outcome, while higher levels of IL-6 and TNF-α corresponded to a severely abnormal neurological outcome, at 12 months of age. Elevated serum levels of IL-6 and TNF-α better corresponded with hypoxia/ischemia compared to CSF values, within 96 hours of birth. Also, higher serum levels of IL-6, TNF-α, and IL-18 corresponded better with abnormal neurological outcome at 12 months of age, compared to CSF values.