title: Association of brain injury and neonatal cytokine response during therapeutic hypothermia in newborns with hypoxic-ischemic encephalopathy.
abstract: Cytokines have been proposed as mediators of neonatal brain injury via neuroinflammatory pathways triggered by hypoxia-ischemia. Limited data are available on cytokine profiles in larger cohorts of newborns with hypoxic-ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH).
  
  
  
  Serum cytokines interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-13, tumor necrosis factor-α, and interferon-γ were measured in newborns with HIE at 24 and 72 h of TH. Differences between infants with favorable (survivors with mild/no magnetic resonance imaging (MRI) injury) vs. adverse outcome (death or moderate/severe MRI injury) were compared using mixed models to adjust for covariates.
  
  
  
  Data from 36 term newborns with HIE (favorable outcome: n = 20, adverse outcome: n = 16) were evaluated. Cytokines IL-1β, IL-2, IL-6, IL-8, IL-10, and IL-13 were elevated in the adverse relative to favorable outcome group at 24 h. IL-6 remained significantly elevated in the adverse outcome group at 72 h. IL-6 and IL-10 remained significantly associated with outcome group after controlling for covariates.
  
  
  
  Inflammatory cytokines are elevated in HIE newborns with brain injury by MRI. In particular, IL-6 and IL-10 were associated with adverse outcomes after controlling for baseline characteristics and severity of presentation. These data suggest that cytokine response may identify infants in need of additional neuroprotective interventions.
authors.affiliation: Pediatric Residency Program, Children's National Health System, Washington, District of Columbia.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Orrock
authors.affiliation: Center for Genetic Medicine Research, Children's Research Institute, Washington, District of Columbia.
authors.forename: Karuna
authors.initials: K
authors.lastname: Panchapakesan
authors.affiliation: Department of Diagnostic Imaging and Radiology, Children's National Health System, Washington, District of Columbia.|The George Washington University School of Medicine, Washington, District of Columbia.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Vezina
authors.affiliation: The George Washington University School of Medicine, Washington, District of Columbia.|Department of Neurology, Children's National Health System, Washington, District of Columbia.
authors.forename: Taeun
authors.initials: T
authors.lastname: Chang
authors.affiliation: Department of Neurology, Children's National Health System, Washington, District of Columbia.
authors.forename: Kari
authors.initials: K
authors.lastname: Harris
authors.affiliation: The George Washington University School of Medicine, Washington, District of Columbia.|Division of Biostatistics and Study Methodology, Children's National Health System, Washington, District of Columbia.
authors.forename: Yunfei
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Center for Genetic Medicine Research, Children's Research Institute, Washington, District of Columbia.|The George Washington University School of Medicine, Washington, District of Columbia.
authors.forename: Susan
authors.initials: S
authors.lastname: Knoblach
authors.affiliation: The George Washington University School of Medicine, Washington, District of Columbia.|Division of Neonatology, Children's National Health System, Washington, District of Columbia.
authors.forename: An N
authors.initials: AN
authors.lastname: Massaro
mesh_terms: D001930:Brain Injuries / Q000097:blood*; D015331:Cohort Studies; D016207:Cytokines / Q000097:blood / Q000378:metabolism*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007036:Hypothermia, Induced; D020925:Hypoxia-Ischemia, Brain / Q000097:blood* / Q000628:therapy*; D007231:Infant, Newborn; D007249:Inflammation; D008279:Magnetic Resonance Imaging; D008297:Male; D013997:Time Factors
chemical_list: D016207:Cytokines