Inflammatory response in the central nervous system following perinatal asphyxia
Respuesta inflamatoria en el sistema nervioso central secundaria a asfixia perinatal
MARTIN-ANCEL, A., GARCIA-ALIX, A., PASCUAL-SALCEDO, D., VALCARCEL, M., and QUERO, J.
Department of Pediatrics. Division of Neonatology (A. M. -A., M. V., J. Q.), and the Department of Biochemistry (D. P. -S.). La Paz Children's Hospital. Autonoma University of Madrid, Spain, and the Division of Neonatology, Hospital Materno-Infantil. Las Palmas de Gran Canaria. Spain (A. G. -A.).
Ars Pharmaceutica;37,981-88 (1996)
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ABSTRACT Objectives: To examine the relation of IL-6 levels in the CSF to the severity of hypoxic-ischemic encephalopathy (HIE) and to the outcome. Methods: Asphyxiated term neonates were included. Cerebrospinal fluid (CSF) IL-6 was measured by a sensitive ELISA. Results: 20 neonates were studied: 3 had no HIE, 5 had stage 1, 6 had stage 2, and 6 had stage 3. CSF IL-6 levels (8 to 90 hours of life) were higher in neonates with HIE stage 3 (range 65 to 2250 pg/ml) when compared to neonates with HIE stage 0 to 2 (<2 pg/ml in 12 neonates, 10 pg/ml in 1)(p<0.01). 5 neonates had adverse outcome: 4 died, and 1 had cerebral palsy. 13 had normal outcome. CSF IL-6 levels (10.8±6.1 months) were higher in neonates with adverse outcome (range 65 to 2250 pg/ml) compared to neonates with favorable outcome (p<0.05). Conclusion: IL-6 levels in the CSF are related to neonatal neurological manifestations and to the outcome. Our results suggest that IL-6 is implicated in the pathogenesis of neonatal hypoxic-ischemic brain damage. Key words: Perinatal asphyxia. Cerebral ischemia. Interleukin 6. Tumor necrosis factor.
RESUMEN Objetivos: Examinar la relación entre los niveles de IL-6 en líquido cefalorraquídeo (LCR) con el grado de encefalopatía hipóxico-isquémica (EHI) y la evolución. Métodos: Se estudiaron recién nacidos a término asfixiados. Se determinaron los niveles de IL-6 en LCR mediante ELISA. Resulados: Se incluyeron 20 neonatos: 3 sin EHI, 5 con grado 1, 6 con grado 2, y 6 con grado 3. La concentración de IL-6 en LCR (8 a 90 horas de vida) fue mayor en neonatos con EHI grado 3 (rango 65 a 2250 pg/ml) que en neonatos con EHI grados 0 a 2 (<2 pg/ml en 12 neonatos, 10 pg/ml en 1)(p<0.01). 5 neonatos tuvieron una evolución adversa: 4 murieron, y 1 tuvo parálisis cerebral. 13 presentaron una evolución favorable. Los niveles de IL-6 en LCR (10.8±6.1 meses) fueron mayores en neonatos con evolución adversa (rango 65 a 2250 pg/ml) comparados con neonatos con evolución favorable (p<0.05). Conclusión: Los niveles de IL-6 en LCR se relacionan con el grado de EHI y con la evolución. Nuestros resultados sugieren que la IL-6 está implicada en la patogenia del daño cerebral hipóxico-isquémico neonatal. Palabras clave: Aspfixia perinatal. Isquemia cerebral. Interleucina-6. Factor necrosis tumoral. |