Cerebrospinal fluid cleaved-tau protein and 9-hydroxyoctadecadienoic acid concentrations in pediatric patients with hydrocephalus.

Abstract

OBJECTIVE:

To ascertain if cerebrospinal fluid cleaved-tau protein and 9-hydroxyoctadecadienoic acid, reflecting potential biomarkers of overall neuronal injury and lipid peroxidation, respectively, are elevated in hydrocephalus patients compared with controls, and if cleaved-tau and 9-hydroxyoctadecadienoic acid levels correlate with each other.

DESIGN:

Prospective clinical observational study.

SETTING:

Tertiary-care children's hospital.

PATIENTS:

Children younger than or equal to 18 yrs who underwent ventriculoperitoneal shunt placement or revision surgery for intrinsic hydrocephalus.

MEASUREMENTS AND MAIN RESULTS:

During the study period 12 patients with intrinsic hydrocephalus required ventriculoperitoneal shunt placement or revision. Cerebrospinal fluid cleaved-tau levels were significantly elevated in patients with hydrocephalus (44.7 +/- 9.6 ng/mL, n = 11) compared with control patients (0.0 +/- 0.0 ng/mL, n = 9; p < 0.0001). Cleaved-tau levels correlated with patient age (r = .609, p = 0.047) and duration of symptoms (r = .755, p = 0.007). No significant difference in cerebrospinal fluid 9-hydroxyoctadecadienoic acid levels between patients with hydrocephalus (24.6 +/- 5.7, n = 8) and control patients (24.9 +/- 9.3 ng/mL, n = 7) was detected (p = 0.25). There was also no statistically significant correlation between 9-hydroxyoctadecadienoic acid levels and duration of symptoms (r = .668, p = 0.07), nor was there a significant correlation between 9-hydroxyoctadecadienoic acid levels and patient age (r = -.011, p > 0.10). There was no significant relationship between 9-hydroxyoctadecadienoic acid levels and signs of elevated intracranial pressure, nor was there a correlation between 9-hydroxyoctadecadienoic acid levels and cleaved-tau levels.

CONCLUSION:

Children with hydrocephalus who have clinical signs of increased intracranial pressure and require ventriculoperitoneal shunt placement or revision exhibit markedly elevated cerebrospinal fluid cleaved-tau levels, suggesting evidence of axonal damage. However, this axonal injury does not seem to be associated with significant lipid peroxidation, at least as assessed by quantifying cerebrospinal fluid 9-hydroxyoctadecadienoic acid at a single, concurrent time point. The significant relationship between age and cerebrospinal fluid cleaved-tau levels suggest that brain injury associated with hydrocephalus may be more pronounced in older children.

• Authors: Pelin Cengiz, Frank Zemlan, Richard Ellenbogen, Douglas Hawkins, Jerry J Zimmerman
• Journal: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies (Pediatr Crit Care Med) Vol. 9 Issue 5 Pg. 524-9 (Sep 2008) ISSN: 1529-7535 [Print] United States
• PMID: 18679140 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• Fatty Acids, Unsaturated
• hydroxyoctadecadienoic acid
• tau Proteins

Topics

• Adolescent
• Biomarkers
• Child
• Child, Preschool
• Fatty Acids, Unsaturated (cerebrospinal fluid)
• Female
• Hospitals, Pediatric
• Humans
• Hydrocephalus (cerebrospinal fluid, physiopathology)
• Infant
• Male
• Observation
• Prospective Studies
• Ventriculoperitoneal Shunt
• tau Proteins (cerebrospinal fluid)