Lower levels of Th1 and Th2 cytokines in cerebrospinal fluid (CSF) at the time of initial CSF shunt placement in children are associated with subsequent shunt revision surgeries.

Autor: Simon TD; Children's Hospital Los Angeles, Los Angeles, CA, United States; Department of Pediatrics, University of Southern California, Los Angeles, CA, United States; The Saban Research Institute, Los Angeles, CA, United States. Electronic address: tsimon@chla.usc.edu., Sedano S; Children's Hospital Los Angeles, Los Angeles, CA, United States; Currently University of California San Francisco School of Medicine, San Francisco, CA, United States., Rosenberg-Hasson Y; Human Immune Monitoring Center, Stanford School of Medicine, Palo Alto, CA, United States., Durazo-Arvizu R; Children's Hospital Los Angeles, Los Angeles, CA, United States; The Saban Research Institute, Los Angeles, CA, United States., Whitlock KB; New Harmony Statistical Consulting LLC, Clinton, WA, United States., Hodor P; Aurynia LLC, Seattle, WA, United States., Hauptman JS; Seattle Children's Research Institute, Seattle, WA, United States; Department of Neurosurgery, University of Washington, Seattle, WA, United States., Limbrick DD; St. Louis Children's Hospital, St. Louis, MO, United States; Department of Neurosurgery, Washington University in St. Louis, St. Louis, MO, United States., McDonald P; Division of Neurosurgery, University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Children's Hospital, Vancouver, British Columbia, Canada., Ojemann JG; Seattle Children's Research Institute, Seattle, WA, United States; Department of Neurosurgery, University of Washington, Seattle, WA, United States., Maecker HT; Human Immune Monitoring Center, Stanford School of Medicine, Palo Alto, CA, United States.
Jazyk: angličtina
Zdroj: Cytokine [Cytokine] 2023 Sep; Vol. 169, pp. 156310. Date of Electronic Publication: 2023 Jul 29.
DOI: 10.1016/j.cyto.2023.156310
Abstrakt: Objective: We compare cytokine profiles at the time of initial CSF shunt placement between children who required no subsequent shunt revision surgeries and children requiring repeated CSF shunt revision surgeries for CSF shunt failure. We also describe the cytokine profiles across surgical episodes for children who undergo multiple subsequent revision surgeries.
Methods: This pilot study was nested within an ongoing prospective multicenter study collecting CSF samples and clinical data at the time of CSF shunt surgeries since August 2014. We selected cases where CSF was available for children who underwent an initial CSF shunt placement and had no subsequent shunt revision surgeries during >=24 months of follow-up (n = 7); as well as children who underwent an initial CSF shunt placement and then required repeated CSF shunt revision surgeries (n = 3). Levels of 92 human cytokines were measured using the Olink immunoassay and 41 human cytokines were measured using Luminex based bead array on CSF obtained at the time of each child's initial CSF shunt placement and were displayed in heat maps.
Results: Qualitatively similar profiles for the majority of cytokines were observed among the patients in each group in both Olink and Luminex assays. Lower levels of MCP-3, CASP-8, CD5, CXCL9, CXCL11, eotaxin, IFN-γ, IL-13, IP-10, and OSM at the time of initial surgery were noted in the children who went on to require multiple surgeries. Pro- and anti-inflammatory cytokines were selected a priori and shown across subsequent revision surgeries for the 3 patients. Cytokine patterns differed between patients, but within a given patient pro-inflammatory and anti-inflammatory cytokines acted in a parallel fashion, with the exception of IL-4.
Conclusions: Heat maps of cytokine levels at the time of initial CSF shunt placement for each child undergoing only a single initial CSF shunt placement and for each child undergoing repeat CSF shunt revision surgeries demonstrated qualitatively similar profiles for the majority of cytokines. Lower levels of MCP-3, CASP-8, CD5, CXCL9, CXCL11, eotaxin, IFN-γ, IL-13, IP-10, and OSM at the time of initial surgery were noted in the children who went on to require multiple surgeries. Better stratification by patient age, etiology, and mechanism of failure is needed to develop a deeper understanding of the mechanism of inflammation in the development of hydrocephalus and response to shunting in children.
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Tamara Simon reports financial support was provided by National Institutes of Health. Tamara Simon reports financial support was provided by National Center for Advancing Translational Sciences. David D. Limbrick reports a relationship with Mircobot Medical Inc. that includes: funding grants. No other conflict of interest to disclose.
(Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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