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Inflammatory Markers in Cerebrospinal Fluid from Patients with Hydrocephalus: A Systematic Literature Review
Sara Diana Lolansen1, Nina Rostgaard2, Eva Kjer Oernbo1
1Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark.
Insights
Elevated inflammatory markers in cerebrospinal fluid (CSF) like IL-6 and VEGF are linked to hydrocephalus development. These markers may serve as biomarkers for disease progression and potential therapeutic targets.
Area of Science:
- Neuroscience
- Immunology
- Biochemistry
Background:
- Hydrocephalus is a condition characterized by abnormal accumulation of cerebrospinal fluid (CSF) in the brain.
- The role of inflammation in the development and progression of hydrocephalus remains incompletely understood.
- Identifying specific inflammatory markers in CSF could offer insights into disease mechanisms.
Purpose of the Study:
- To systematically review and evaluate the literature on inflammatory markers in CSF of hydrocephalus patients.
- To identify potential CSF inflammatory markers associated with hydrocephalus development and progression.
Main Methods:
- A systematic review of studies published before December 3rd, 2020, was conducted using PubMed, Embase, and reference lists.
- Studies were screened for eligibility, and data were extracted following PRISMA guidelines.
- Three independent reviewers assessed the included articles for sources of bias.
Main Results:
- Twenty-two studies analyzed CSF from 311 idiopathic normal pressure hydrocephalus (iNPH) patients, 178 with posthemorrhagic hydrocephalus (PHH), 151 with other hydrocephalus diagnoses, and 394 controls.
- Elevated levels of IL-6, IL-1β, and LRG were observed in iNPH patients' CSF.
- PHH patients showed increased IL-6, IL-18, and VEGF in CSF, while IFN-γ was elevated in other hydrocephalus diagnoses.
Conclusions:
- Interleukin-6 (IL-6), IL-1β, Leukocyte Related Gene (LRG), IL-18, Vascular Endothelial Growth Factor (VEGF), and Interferon-gamma (IFN-γ) are elevated in the CSF of hydrocephalus patients.
- These inflammatory markers may play a role in promoting hydrocephalus development and progression.
- These markers could serve as novel biomarkers and their pathways as targets for hydrocephalus treatment.
Objective:
The aim of this systematic review was to evaluate existing literature on inflammatory markers in CSF from patients with hydrocephalus and identify potential markers capable of promoting hydrocephalus development and progression.
Methods:
Relevant studies published before December 3rd 2020 were identified from PubMed, Embase, and reference lists. Studies were screened for eligibility using the predefined inclusion and exclusion criteria. Data from eligible studies were extracted, and sources of bias were evaluated. We included articles written in English investigating inflammatory markers in CSF from patients with hydrocephalus and control subjects. The review was conducted according to the PRISMA guidelines by three independent reviewers.
Results:
Twenty-two studies analyzed CSF from 311 patients with idiopathic normal pressure hydrocephalus (iNPH), 178 with posthemorrhagic hydrocephalus (PHH), 151 with other hydrocephalus diagnoses, and 394 control subjects. Fifty-eight inflammatory markers were investigated. The CSF of iNPH patients had increased CSF levels of IL-6, IL-1β, and LRG compared with control subjects, whereas the CSF of PHH patients had increased levels of IL-6, IL-18, and VEGF. CSF from patients with "other hydrocephalus diagnoses" had elevated IFN-γ compared to control subjects, and VEGF was increased in congenital hydrocephalus, spina bifida, and hydrocephalus associated with tuberculous meningitis compared with controls.
Conclusion:
IL-6, IL-1β, LRG, IL-18, VEGF, and IFN-γ are elevated in CSF from patients with hydrocephalus and may be involved in promotion of hydrocephalus development and progression. They may serve as novel disease biomarkers, and their signaling pathways may represent targets for pharmacological management of hydrocephalus.
