ABSTRACT
Lumbar CSF eicosanoids were measured in 11 neonates with perinatal asphyxia and 12 neonates with suspected sepsis. In the asphyxia group low levels of thromboxane B2 and prostaglandin F2a were detected in five neonates, all of which had had a lumbar puncture prior to 4 hours of age. In the group with suspected sepsis two infants had positive blood cultures and one had strep meningitis. CSF eicosanoids were nondetectable in all patients in this second group with the exception of the infant with meningitis. With meningitis CSF eicosanoids were markedly elevated. These findings suggest that lumbar CSF eicosanoids do not appear to be a clinically useful tool. The data further suggest that eicosanoids are involved in the inflammatory response to meningitis.
Subject(s)
Eicosanoic Acids/cerebrospinal fluid , Infant, Newborn/cerebrospinal fluid , Asphyxia Neonatorum/cerebrospinal fluid , Dinoprost/cerebrospinal fluid , Humans , Lumbosacral Region , Radioimmunoassay , Sepsis/cerebrospinal fluid , Thromboxane B2/cerebrospinal fluidABSTRACT
Recent evidence has shown that a variety of prostaglandins and leukotrienes can be produced in brain tissue after injury in animals. It has also been speculated that increases in brain prostaglandins occur in humans following injury. Ventricular cerebrospinal fluid (CSF) samples have been obtained from children with static lesions (controls) as well as children with acute brain injury and eicosanoids measured by immunologic techniques. Metabolites of prostacyclin (6-keto-PGF1 a) and thromboxane A2 (thromboxane B2) were the major eicosanoids found in CSF, and levels of these compounds were increased 3-10 times in acutely injured patients. Prostaglandin E2 was also found in lower amounts, although in one case its level was very high. Prostaglandin D2 was also present, but in low amounts. No leukotrienes were found in CSF samples that were purified by HPLC prior to immunoassay. Elevated levels of hydroxyeicosatetraenoic acids (HETEs) were observed in those samples stored frozen, but these metabolites were most probably due to autooxidation of arachidonic acid in CSF. Arachidonic acid concentration in CSF was typically found to be in the range of 10-200 ng/ml, but was found to be 5-10 fold higher in one severely injured patient. Thus, elevated free arachidonic acid and various oxygenated metabolites were observed in CSF following brain injury.
Subject(s)
Brain Injuries/metabolism , Cerebral Ventricles/analysis , Eicosanoic Acids/cerebrospinal fluid , 12-Hydroxy-5,8,10,14-eicosatetraenoic Acid , 6-Ketoprostaglandin F1 alpha/cerebrospinal fluid , Adolescent , Arachidonic Acid , Arachidonic Acids/cerebrospinal fluid , Child , Child, Preschool , Chromatography, High Pressure Liquid , Dinoprostone , Humans , Hydroxyeicosatetraenoic Acids/cerebrospinal fluid , Infant , Infant, Newborn , Leukotriene B4/cerebrospinal fluid , Prostaglandin D2 , Prostaglandins D/cerebrospinal fluid , Prostaglandins E/cerebrospinal fluid , SRS-A/cerebrospinal fluid , Thromboxane B2/cerebrospinal fluidABSTRACT
We investigated effects of exogenous norepinephrine and isoproterenol on pial arterial diameter and cerebral eicosanoid synthesis in anesthetized newborn pigs. Norepinephrine in artificial cerebrospinal fluid (CSF) constricted pial arteries from 203 +/- 27 micron (X +/- S.E.M.) to 164 +/- 18 micron (20 +/- 2%) (n = 21 vessels from 16 animals) at 10(-4) M. In the same animals, norepinephrine caused the concentration in CSF of 6-keto-prostaglandin F1 alpha to increase from 768 +/- 91 to 1544 +/- 151 pg/ml, thromboxane B2 to increase from 188 +/- 37 to 269 +/- 38 pg/ml, and prostaglandin E2 to increase from 2067 +/- 448 to 6575 +/- 751 pg/ml. Topical application of prostaglandin E2 in CSF to the cortical surface demonstrated that concentrations as low as 10,000 pg/ml were able to dilate pial arteries substantially. Blockade of cyclo-oxygenase activity by indomethacin (5-10 mg/kg, i.v.) potentiated pial arterial constriction to norepinephrine. Topical isoproterenol dilated pial arteries, but isoproterenol did not affect levels of measured eicosanoids in CSF. We conclude that norepinephrine elicits release of prostanoids from the cortical surface, and that these substances limit cerebrovascular constriction to norepinephrine.
Subject(s)
Cerebral Arteries/drug effects , Cerebral Cortex/drug effects , Eicosanoic Acids/cerebrospinal fluid , Norepinephrine/pharmacology , Animals , Animals, Newborn , Cerebral Cortex/blood supply , Cerebral Cortex/metabolism , Female , Isoproterenol/pharmacology , Male , Prostaglandins E/pharmacology , SwineABSTRACT
To detect and identify lipid peroxides in the CFS following subarachnoid hemorrhage (SAH), CSF samples were obtained sequentially from 10 patients who developed typical vasospasm and were analyzed by HPLC and gas chromatography-mass spectrometry. One of the peaks appearing on the 7th day after SAH was identified as 5-hydroxy eicosatetraenoic acid. On HPLC, an identical peak was detected in samples from other SAH patients. The results gave unequivocal evidence that peroxides of arachidonic acid are present in the CSF following SAH, and a correlation between them and the occurrence of vasospasm seemed likely. The hypothesis that lipid peroxides are involved in the genesis of vasospasm deserves further investigation.
