Procollagen I C-propeptide in the cerebrospinal fluid of neonates with posthaemorrhagic hydrocephalus.
BACKGROUND
The pathogenesis of posthaemorrhagic hydrocephalus (PHHC) following intraventricular haemorrhage (IVH) in premature infants includes a fibroproliferative reaction leading to arachnoidal fibrosis, ultimately causing malresorption of cerebrospinal fluid (CSF) at the arachnoid villi.


OBJECTIVE
To determine whether an increased concentration of the carboxyterminal propeptide of type I procollagen (PICP) in the CSF of neonates after IVH reflects the activation of collagen synthesis preceding the manifestation of PHHC.


METHODS
From 20 neonates with PHHC (median birth weight 740 g, median gestational age 25+1 weeks), 52 CSF samples were collected. CSF samples of four neonates (median birth weight 2170 g, median gestational age 32+4 weeks) with congenital non-haemorrhagic hydrocephalus served as controls. PICP was measured by radioimmunoassay.


RESULTS
PICP in CSF taken at the start of external CSF drainage (median day 21, range 17-25 days postnatal age) was significantly increased (median 851.5, range 153.5-1944 microg/l) compared with controls (median 136.1, range 33.8-169.5 microg/l). CSF concentrations of PICP declined until permanent shunt placement (median day 70, range days 41-113).


CONCLUSIONS
In neonates who develop PHHC, significant elevation of PICP concentration in the CSF is present 3-4 weeks after IVH. It reflects the increase of local type I collagen turnover, thereby correlating with manifestation of PHHC.
Heep
A
A
Department of Neonatology, University of Bonn, Germany. a.heep@uni-bonn.de
Stoffel-Wagner
B
B
Soditt
V
V
Aring
C
C
Groneck
P
P
Bartmann
P
P
D001724:Birth Weight; D002543:Cerebral Hemorrhage / Q000134:cerebrospinal fluid* / Q000150:complications / Q000151:congenital; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000134:cerebrospinal fluid* / Q000209:etiology; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000134:cerebrospinal fluid*; D008297:Male; D010446:Peptide Fragments / Q000134:cerebrospinal fluid*; D011347:Procollagen / Q000134:cerebrospinal fluid*; D011446:Prospective Studies; D011863:Radioimmunoassay / Q000379:methods
D010446:Peptide Fragments; D011347:Procollagen; C042813:procollagen type I carboxy terminal peptide