Arachidonic acid metabolites in CSF in hypoxic-ischaemic encephalopathy of newborn infants.

The aim of this study was to evaluate the cerebral synthesis of eicosanoids in the asphyctic newborn and to investigate the relation between the prostanoid profiles in cerebrospinal fluid (CSF) and the appearance and severity of hypoxic-ischaemic encephalopathy (HIE). Levels of 6-keto-PGF(1-alpha), TXB2, PGE2 and PGF(2-alpha), in CSF were measured in 40 full term newborns during the first day of life. Thirty of these newborns had birth asphyxia and were divided into three groups: 10 without HIE, 12 with mild HIE and 8 with moderate-severe HIE. They were compared to a control group of 10 non-hypoxic newborns. Determinations of the metabolites in CSF were performed by RIA and expressed as pg/ml (mean +/- SD). The CSF TXB2 (thromboxane A2 metabolite) in asphyxiated newborns was always higher than in the control group (28.12 +/- 10.6), and related to the severity of HIE (p = 0.005): without HIE (50.84 +/- 16.4; p = 0.02), mild HIE (80.65 +/- 12.64; p < 0.01) and moderate-severe HIE (178.14 +/- 20.5; p < 0.01). The CSF 6-keto-PGF(1-alpha) (prostacyclin metabolite) in asphyxiated newborns was always higher than in the control group (80.55 +/- 12.56), but indirectly related to the severity of HIE: without HIE (240.95 +/- 28.12; p < 0.01), mild HIE (183.65 +/- 30.1; p < 0.01) and moderate-severe HIE (140.55 +/- 25.12; p < 0.01). In the moderate-severe HIE group, the increase in TXB2 was higher than the rise in 6-keto-PGF(1-alpha).