Neural progenitors populate the cerebrospinal fluid of preterm patients with hydrocephalus

To evaluate cerebrospinal fluid (CSF) of preterm patients with hydrocephalus for neural progenitors.

This report describes a prospective study of CSF obtained from preterm infants, either with progressive posthemorrhagic hydrocephalus (PPHH) or without known intercranial pathology. Cells recovered by centrifugation were analyzed by reverse transcriptase-polymerase chain reaction or by immunocytometry. Alternatively, cells were cultured by using methods permissive to neural progenitor growth and analyzed by immunocytochemistry and Western blotting.

Human CSF cells were obtained from 20 preterm infants at approximately 27 weeks estimated gestational age (15 infants with PPHH, 5 control infants). The number of these cells removed over time from patients with PPHH were substantial, based on our calculations. Cells recovered from patients with PPHH transcribe markers for neural progenitors, all the mature cells types of the central nervous system, and a large battery of chondroitin sulfate proteoglycan genes, including the entire aggrecan/lectican family. These cells proliferated in culture, and precursor markers were detected by Western blotting, immunocytochemistry, and cytometry. Cells could not be cultured from control patients.

Neural progenitor accumulation in CSF could confound the clinical interpretation of CSF cell counts in hydrocephalus and may play as yet undetermined roles in the biology of injury after hydrocephalus. These findings suggest the potential for neural stem cell propagation from CSF.