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Inflammatory Markers in the Blood of Spastic Cerebral Palsy Children: A Case-Control Study
Özlem Tezol1, Sıddika Songül Yalçın2, Gözde Girgin3
1Department of Pediatrics, Faculty of Medicine, Mersin University, 33110 Mersin, Türkiye.
Insights
Children with spastic cerebral palsy (CP) show altered levels of key inflammatory and nutritional biomarkers. Specifically, neopterin and kynurenine (Kyn) are lower, while vitamin D (VitD), vitamin D binding protein (VDBP), and erythrocyte folate are higher in CP patients compared to controls.
Area of Science:
- Biochemistry
- Immunology
- Pediatrics
Background:
- Cerebral palsy (CP) is a complex neurological disorder with potential links to inflammatory processes and nutritional status.
- Investigating biomarkers related to inflammation and nutrient metabolism may offer insights into CP pathophysiology.
Purpose of the Study:
- To simultaneously assess inflammatory biomarkers (neopterin, kynurenine/tryptophan pathway), vitamin D (VitD), vitamin D binding protein (VDBP), and erythrocyte folate in children with spastic CP.
- To explore correlations between these biomarkers and clinical severity (GMFCS).
Main Methods:
- A case-control study involving 50 children with spastic CP and 55 healthy controls aged 3-10 years.
- Measurement of serum neopterin, tryptophan (Trp), Kyn, 25OHD, plasma VDBP, and erythrocyte folate.
- Evaluation of indoleamine-2,3-dioxygenase 1 (IDO-1) activity via the Kyn/Trp ratio and correlation analysis with GMFCS.
Main Results:
- Children with CP exhibited lower serum neopterin, Trp, and Kyn levels compared to controls.
- Elevated levels of VitD, VDBP, and erythrocyte folate were observed in the CP group.
- Neopterin showed a positive correlation with the Gross Motor Function Classification System (GMFCS) level in children with CP.
Conclusions:
- Children with spastic CP present a distinct biomarker profile with lower neopterin and Kyn, but higher VitD, VDBP, and erythrocyte folate.
- The findings suggest a complex interplay of inflammatory and anti-inflammatory processes, alongside altered nutritional status, in CP.
- Further research is required to fully elucidate the inflammatory and anti-inflammatory status in children with CP.
Objectives:
The aim was to simultaneously investigate inflammatory biomarkers, neopterin, the kynurenine/tryptophan (Kyn/Trp) pathway, vitamin D (VitD), vitamin D binding protein (VDBP), and erythrocyte folate, in cerebral palsy (CP).
Methods:
A case-control study was conducted at Mersin University Hospital. Three- to ten-year-old patients with spastic CP (n = 50) and age- and gender-matched healthy controls (n = 55) were included. Serum levels of neopterin, Trp, Kyn and 25OHD, plasma VDBP, and erythrocyte folate concentrations were measured. Indoleamine-2,3-dioxygenase 1 (IDO-1) enzyme activity was evaluated according to the Kyn/Trp ratio. Comparison and correlation analyses were performed.
Results:
The levels of neopterin, Trp, and Kyn were lower in children with CP than in healthy controls (p = 0.037, p < 0.001, and p = 0.003, respectively). IDO1 was not significantly different between the CP and control groups (p = 0.214). The levels of VitD and VDBP were higher in children with CP (p < 0.001 and p = 0.001, respectively). The level of erythrocyte folate was also higher in children with CP (p < 0.001). No significant correlation was found between age and inflammatory biomarkers in the CP group. Neopterin was correlated with the level of Gross Motor Function Classification System (GMFCS) level (r = 0.292, p = 0.044), while there was no significant correlation between the other biomarkers and the level of GMFCS in the CP group.
Conclusions:
Inflammatory biomarkers of neopterin and Kyn are lower, inflammatory biomarkers of VDBP and erythrocyte folate are higher, and anti-inflammatory VitD is higher in children with spastic CP compared to healthy children. More knowledge is needed to demonstrate inflammatory and anti-inflammatory status in children with CP.
