INTERLEUKIN-6 IN THE CEREBROSPINAL-FLUID AFTER PERINATAL ASPHYXIA IS RELATED TO EARLY AND LATE NEUROLOGICAL MANIFESTATIONS

Objectives. To investigate if the concentration of interleukin-6 (IL-6 ) in the cerebrospinal fluid (CSF) is affected by perinatal asphyxia, and to examine the relation of IL-6 levels in the CSF to the severity of hypoxic-ischemic encephalopathy (HIE), to brain damage, and to the neurological outcome. Methods. Asphyxiated term neonates were included . Cerebrospinal fluid IL-6 was measured by a sensitive enzyme-linked i mmunosorbent assay. Results. Twenty neonates were studied: 3 had no HI E, 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 with neonates with HIE stage 0 to 2 ( <2 pg/mL in 12 neonates, 10 pg/mL in 1). According to neuroimaging tec hniques and/or pathological examination, 14 neonates were normal, and 5 showed signs of brain damage; 1 was not classified. CSF IL-6 levels were significantly higher in neonates with signs of brain damage. Fina lly, 5 neonates had adverse outcomes (4 died, 1 had cerebral palsy), 2 had mild motor impairment, and 13 had normal outcomes. CSF IL-6 level s were higher in neonates with adverse outcomes (range, 65 to 2250 pg/ mL) compared with neonates with favorable outcomes. Conclusion. The ma gnitude of IL-6 response in the CSF after perinatal asphyxia is relate d to the severity of neonatal HIE, to brain damage, and to the neurolo gical outcome. Our results suggest that IL-6 might play a role in neon atal hypoxic-ischemic brain damage.