Neonatal encephalopathy: Association of cytokines with MR spectroscopy and outcome
Neonatal encephalopathy: Association of cytokines with MR spectroscopy and outcome
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DOI：
10.1203/01.pdr.0000144819.45689.bb
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发表时间：
2004-12-01
影响因子：
3.6
通讯作者：
Ferriero, DM
中科院分区：
文献类型：
--
作者：
Bartha, AI;Foster-Barber, A;Ferriero, DM
对于足月新生儿脑病，人们对早期炎症标志物、新生儿脑损伤和长期神经发育结果之间的关系知之甚少。我们的目标是确定新生儿血清细胞因子水平是否与质子磁共振波谱 (MRS) 评估的脑代谢、磁共振成像 (MRI) 异常以及 30 个月时的神经发育结果相关。在由 62 名有新生儿脑病风险的足月新生儿组成的前瞻性队列中，通过免疫亲和色谱法测量干燥新生儿血液中七种细胞因子 [IL-1beta、IL-6、IL-8、IL-9、IL-12、IL-13 和肿瘤坏死因子 (TNF)-α] 的水平。对 MR 图像 (n = 61) 进行评分，并在生命中位第 6 天通过 MRS (n = 42) 测量深灰核 (DGN) 和分水岭/皮质区 (WS) 中的乳酸/胆碱和 N-乙酰天冬氨酸 (NAA)/胆碱。如果婴儿死亡或在 30 个月时检测到认知延迟和/或功能性运动缺陷，则神经发育结果 (n = 54) 被视为异常。在 DGN 中，IL-1β、IL-6、IL-8 和 TNF-α 与乳酸/胆碱显着相关（分别为 p = 0.03、0.02、0.03 和 0.01），但在 WS 中则不然（全部 p > 0.1）。细胞因子与任何区域的 NAA/胆碱或 MRI 评分均无关。神经发育结果异常的儿童的新生儿 IL-10、IL-6、IL-8 水平较高，而 IL-12 水平较低（分别为 p = 0.04、0.03、0.01、0.03）。炎症细胞因子升高与脑氧化代谢受损有关，但与新生儿期可检测到的 MRI 变化无关。了解细胞因子升高与结果之间的联系将为脑保护的新策略提供信息。
In term neonatal encephalopathy, little is known about the relationship between early inflammatory markers, neonatal brain injury, and long-term neurodevelopmental outcome. Our goal was to determine whether neonatal serum cytokine levels are associated with cerebral metabolism assessed by proton magnetic resonance spectroscopy (MRS), with magnetic resonance imaging (MRI) abnormalities, and with neurodevelopmental outcome at 30 mo of age. Levels of seven cytokines [IL-1beta, IL-6, IL-8, IL-9, IL-12, IL-13, and tumor necrosis factor (TNF)-alpha] were measured in dried neonatal blood by immunoaffinity chromatography in a prospective cohort of 62 term newborns at risk of neonatal encephalopathy. MR images (n = 61) were scored and lactate/choline and N-acetyl-aspartate (NAA)/choline were measured by MRS (n = 42) on median day of life 6 in the deep gray nuclei (DGN) and in the watershed/cortical zone (WS). Neurodevelopmental outcome (n = 54) was considered abnormal if the infant died or if cognitive delay and/or functional motor deficit were detected at 30 mo. IL-1beta, IL-6, IL-8 and TNF-alpha were significantly associated with lactate/choline in the DGN (p = 0.03, 0.02, 0.03, and 0.01 respectively), but not in the WS (all p > 0.1). Cytokines were not associated with NAA/choline in any region or with MRI scores. Children with abnormal neurodevelopmental outcome had higher neonatal levels of IL-10, IL-6, IL-8, and lower levels of IL-12 (p = 0.04, 0.03, 0.01, 0.03 respectively). Elevated inflammatory cytokines were associated with impaired cerebral oxidative metabolism, but not with detectable MRI changes in the neonatal period. Understanding the link between elevated cytokines and outcome would inform novel strategies of cerebral protection.