In:
Neonatology, S. Karger AG, Vol. 88, No. 1 ( 2005), p. 1-11
Abstract:
〈 i 〉 Background: 〈 /i 〉 Progressive post-hemorrhagic hydrocephalus in preterm infants strongly predicts abnormal neurologic development, and often accompanies cystic periventricular leukomalacia (cPVL). Transforming growth factor-β 〈 sub 〉 1 〈 /sub 〉 (TGF-β 〈 sub 〉 1 〈 /sub 〉 ), associated with hydrocephalus, can upregulate the chondroitin sulfate proteoglycan (CSPG) synthesis. To date, CSPG and their nitrated metabolites (NT-CSPG) have not been evaluated in hydrocephalus. 〈 i 〉 Objectives: 〈 /i 〉 We hypothesized that TGF-β 〈 sub 〉 1 〈 /sub 〉 , TGF-β 〈 sub 〉 2 〈 /sub 〉 , CSPG, and NT-CSPG would accumulate in cerebrospinal fluid (CSF) in preterm hydrocephalus, and their concentrations would correlate with poor long-term outcomes. 〈 i 〉 Methods: 〈 /i 〉 TGF-β 〈 sub 〉 1 〈 /sub 〉 , TGF-β 〈 sub 〉 2 〈 /sub 〉 , CSPG, and NT-CSPG concentrations in CSF were measured prospectively by ELISA in 29 preterm newborns with (n = 22) or without (n = 34) progressive post-hemorrhagic hydrocephalus, and correlated with progressive neonatal hydrocephalus and neurologic outcome. Only concentrations from each patient’s initial CSF sample were used for statistical analysis. 〈 i 〉 Results: 〈 /i 〉 Compared to neonates without hydrocephalus, CSF [TGF-β 〈 sub 〉 1 〈 /sub 〉 ], [TGF-β 〈 sub 〉 2 〈 /sub 〉 ], [CSPG] and [NT-CSPG] were significantly greater by 〉 3-, 〉 35-, 〉 8-, and 〉 3-fold, respectively. Unlike CSF [TGF-β 〈 sub 〉 2 〈 /sub 〉 ] and [CSPG] , [TGF-β 〈 sub 〉 1 〈 /sub 〉 ] correlated with CSF [total protein] . Only CSF [NT-CSPG] correlated with cPVL. Unlike [TGF-β 〈 sub 〉 2 〈 /sub 〉 ] or [CSPG] , [NT-CSPG] correlation with preterm progressive post-hemorrhagic hydrocephalus (PPHH) was explained entirely by the presence of cPVL among these patients. [TGF-β 〈 sub 〉 2 〈 /sub 〉 ] was 〉 20-fold greater in preterm survivors who required a ventriculoperitoneal shunt for PPHH (n = 9), as compared to survivors who did not require a shunt (n = 2), or those without hydrocephalus (n = 12). [TGF-β 〈 sub 〉 2 〈 /sub 〉 ] and [NT-CSPG] correlated inversely with Bayley Index Scores (15.0 months median adjusted age). 〈 i 〉 Conclusions: 〈 /i 〉 This is the first report that [TGF-β 〈 sub 〉 2 〈 /sub 〉 ], [CSPG] , and [NT-CSPG], measured well before term, accumulate abnormally in preterm progressive post-hemorrhagic hydrocephalus CSF, and correlate with adverse neurologic outcome.
Type of Medium:
Online Resource
ISSN:
1661-7800
,
1661-7819
Language:
English
Publisher:
S. Karger AG
Publication Date:
2005
detail.hit.zdb_id:
2403535-X
SSG:
12
Bookmarklink