Skip to main content
  • Oral presentation
  • Open access
  • Published:

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

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.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Deborah Sival.

Rights and permissions

Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reprints and permissions

About this article

Cite this article

Heep, A., Felderhoff-Mueser, U., Schmitz, T. et al. High pressure hydrocephalus in neonates is associated with increased CSF concentrations of interleukin-18 and interferon gamma. Fluids Barriers CNS 4 (Suppl 1), S48 (2007). https://doi.org/10.1186/1743-8454-4-S1-S48

Download citation

  • Published:

  • DOI: https://doi.org/10.1186/1743-8454-4-S1-S48

Keywords