Volume 4 Supplement 1

51st Annual Meeting of the Society for Research into Hydrocephalus and Spina Bifida

Open Access

High pressure hydrocephalus in neonates is associated with increased CSF concentrations of interleukin-18 and interferon gamma

  • Axel Heep1,
  • Ursula Felderhoff-Mueser2,
  • Thomas Schmitz2,
  • Arie Bos3,
  • Eelco Hoving4,
  • Carlo Schaller6 and
  • Deborah Sival3, 5Email author
Cerebrospinal Fluid Research20074(Suppl 1):S48

DOI: 10.1186/1743-8454-4-S1-S48

Published: 20 December 2007

Background

High pressure hydrocephalus (HC) is associated with micro-glial activation and subsequent white matter damage. In addition to high pressure and ischemia, chronic inflammation may be pathophysiologically involved. In a rat model for HC (HTx rat, based on aqueduct stenosis), anti-inflammatory treatment reduces micro-glial scarring (Miller, 2006 CSFR). In human HC, immuno-regulatory processes involved in white matter damage are still largely undefined. Under various pathological conditions, increased CSF interleukin-18 (IL-18; expressed in micro-glial cells) and interferon gamma (IFNg; expressed in natural killer cells affecting oligodendrocytes) concentrations relate with white matter damage. We hypothesize that CSF IL-18 and IFNg concentrations are increased in neonatal high pressure HC, irrespective of underlying etiology.

Materials and methods

In 45 neonates with congenital high pressure HC (n = 30) CSF IL-18 and IFNg concentrations were determined (ELISA). HC neonates were grouped according to aetiology. Group 1: HC in spina bifida aperta (n = 20), group 2: triventricular non-hemorrhagic HC (n = 4), group 3: post hemorrhagic HC after fetal intracerebral hemorrhage (n = 6). Low risk neonates who underwent lumbar puncture for exclusion of meningitis (and appeared negative) served as controls (n = 15).

Results

In the three groups of HC neonates, IL-18 concentrations were significantly higher than in controls [medians and range; controls: 12.5 (12.5–158) pg/ml; group 1: 80 (23–232) pg/ml; group 2: 66 (55–226) pg/ml; group 3: 223 (103–406) pg/ml (each group vs. controls, p < 0.01; group 3 vs. group 1, p < 0.01)]. Similarly, IFNg concentrations were significantly higher in CSF of the 3 HC groups [controls: 8 (8–22) pg/mL; group 1: 35 (12–139) pg/ml; group 2: 22 (15–28) pg/mL; group 3: 22 (17–56) pg/mL (each group vs. controls, p < 0.01; between the groups, NS.

Conclusion

Irrespective of underlying aetiology, neonatal high pressure HC is associated with increased CSF IL-18 and IFNg concentrations. The increased CSF concentrations reflect their pathophysiological involvement in inflammatory white matter damage. We hypothesize that early anti-inflammatory treatment could ameliorate cerebral white matter damage in human neonatal HC.

Authors’ Affiliations

(1)
Dept of Neonatology, University of Bonn
(2)
Dept of Neonatology, Charité, Campus Virchow, Klinikum Universitätsmedizin Berlin
(3)
Dept of Pediatrics, University Medical Center, University of Groningen
(4)
Dept of Neurosurgery, University Medical Center, University of Groningen
(5)
Dept of Pediatric Neurology, University Medical Center, University of Groningen
(6)
Dept of Neurosurgery, University of Bonn

Copyright

© Heep et al; licensee BioMed Central Ltd. 2007

This article is published under license to BioMed Central Ltd.

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