title: CSF cytokine levels in preterm infants may reflect systemic inflammation and are independent of gestation.
abstract: BACKGROUND
  Among preterm infants, high concentrations of inflammatory mediators in cerebrospinal fluid (CSF) are associated with poor outcome. Previous studies have not indicated whether CSF concentrations of inflammatory mediators are associated with important confounders such as gestational age.
  
  
  OBJECTIVE
  To examine associations between CSF concentrations of inflammatory mediators and gestational age, maternal features suggestive of inflammation, characteristics of the CSF sample or the presence of a systemic inflammatory response.
  
  
  METHODS
  Aliquots of CSF obtained during routine investigation of potential sepsis among infants born before 35 weeks gestation were assayed for 17 mediators of inflammation using a fluorescent multi-bead analyser. Other information was collected from routine clinical records.
  
  
  RESULTS
  39 infants were assessed. CSF levels of mediators of inflammation were not correlated with gestational age. CSF red blood cell counts were correlated with CSF concentrations of IL-6, GM-CSF and IL-17 (each p<0.003). CSF lactate was correlated with CSF concentrations of IL-1beta, IL-6, GM-CSF, G-CSF, IFN-gamma and MIP-1beta. CSF concentrations of IL-1beta, IL-6, G-CSF, TNF-alpha and IFN-gamma were higher in infants with a raised CRP within 24 h of delivery (each p<0.003).
  
  
  CONCLUSIONS
  CSF concentrations of inflammatory mediators most probably reflect inflammatory pathologies and are not influenced by gestational age. They may also, however, reflect contamination with blood or systemic inflammation. CSF concentrations of inflammatory mediators may not provide a specific indicator of CNS inflammation.
authors.affiliation: Neonatal Unit, Liverpool Women's Hospital, Crown Street, Liverpool, United Kingdom.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Turner
authors.forename: Jo A
authors.initials: JA
authors.lastname: Drury
authors.forename: Andrew
authors.initials: A
authors.lastname: Carlin
authors.forename: Susan
authors.initials: S
authors.lastname: O'Neill
authors.forename: David
authors.initials: D
authors.lastname: Pilling
authors.forename: Nik
authors.initials: N
authors.lastname: Barnes
authors.forename: Paul
authors.initials: P
authors.lastname: Balmer
authors.forename: Paul
authors.initials: P
authors.lastname: Newland
authors.forename: Simon
authors.initials: S
authors.lastname: Clark
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Kissack
authors.forename: Nimish V
authors.initials: NV
authors.lastname: Subhedar
mesh_terms: D016207:Cytokines / Q000134:cerebrospinal fluid*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007249:Inflammation / Q000134:cerebrospinal fluid*; D011247:Pregnancy
chemical_list: D016207:Cytokines