CYTOKINE RESPONSE IN CEREBROSPINAL-FLUID AFTER BIRTH ASPHYXIA

Experimental studies suggest that cytokine-mediated inflammatory react ions are important in the cascade leading to hypoxic-ischemic brain in jury. The purpose was to study the content of pro-and antiinflammatory cytokines in cerebrospinal fluid (CSF) of asphyxiated and control inf ants. Samples of CSF were obtained from 20 infants who fulfilled the c riteria of birth asphyxia and from seven newborn control subjects. The concentrations of IL-1 beta, IL-8, IL-10, tumor necrosis factor (TNF) -alpha, and granulocyte/monocyte colony-stimulating factor (GM-CSF) we re determined with ELISA and of IL-6 using a bioassay. The concentrati on of IL-6 (pg/mL) was higher in asphyxiated (250, 35-543; median, int erquartile range) than in control (0, 0-18) infants (p = 0.001). There was also a significant relationship between IL-6 and the degree of HI E, and between IL-6 and outcome. In addition, the content of IL-8 (pg/ mL) was higher (p = 0.009) in the asphyxia group (170, 70-1440), than in the the control group (10, 0-30) and there was an association betwe en IL-8 and degree of HIE. The levels of IL-10, TNF-alpha, GM-CSF, and IL-1 beta did not differ between groups. In conclusion, the proinflam matory cytokines IL-6 and IL-8 were markedly elevated in CSF of asphyx iated infants, and the intrathecal levels of these cytokines correspon ded to the degree of HIE.