title: Cytokines and posthemorrhagic ventricular dilation in premature infants.
abstract: OBJECTIVE
  To determine in extremely low-birth-weight infants if elevated blood interferon-γ (IFN-γ), interleukin (IL)-1β, IL-18, tumor necrosis factor-α (TNF-α), and transforming growth factor-β are associated with need for shunt following severe intraventricular hemorrhage (IVH) or with ventricular dilation following milder grades/no IVH.
  
  
  METHODS
  Whole blood cytokines were measured on postnatal days 1, 3, 7, 14, and 21. Maximum IVH grade in the first 28 days, and shunt surgery or ventricular dilation on subsequent ultrasound (28 days' to 36 weeks' postmenstrual age) were determined.
  
  
  RESULTS
  Of 902 infants in the National Institute of Child Health and Human Development Neonatal Research Network Cytokine study who survived to 36 weeks or discharge, 3.1% had shunts. Of the 12% of infants with severe (grade III to IV) IVH, 26% had a shunt associated with elevated TNF-α. None of the infants without IVH (69%) or with grade I (12%) or II (7%) IVH received shunts, but 8.4% developed ventricular dilation, associated with lower IFN-γ and higher IL-18.
  
  
  CONCLUSIONS
  Statistically significant but clinically nondiscriminatory alterations in blood cytokines were noted in infants with severe IVH who received shunts and in those without severe IVH who developed ventricular dilation. Blood cytokines are likely associated with brain injury but may not be clinically useful as biomarkers for white matter damage.
authors: Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35249, USA. ambal@uab.edu
authors: Namasivayam
authors: N
authors: Ambalavanan
authors: Waldemar A
authors: WA
authors: Carlo
authors: Scott A
authors: SA
authors: McDonald
authors: Abhik
authors: A
authors: Das
authors: Diana E
authors: DE
authors: Schendel
authors: Poul
authors: P
authors: Thorsen
authors: David M
authors: DM
authors: Hougaard
authors: Kristin
authors: K
authors: Skogstrand
authors: Rosemary D
authors: RD
authors: Higgins
mesh_terms: D002543:Cerebral Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging; D002552:Cerebral Ventricles / Q000473:pathology* / Q000601:surgery*; D016207:Cytokines / Q000097:blood*; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D014463:Ultrasonography; D017287:Ventriculoperitoneal Shunt / Q000706:statistics & numerical data*
chemical_list: D016207:Cytokines