The Influence of Erythropoietin and Proinflammatory Cytokines in the Development of Cerebral Palsy

Erythropoietin (EPO) is a pleiotropic cytokine, which plays a neuroprotective role. Immune abnormalities have a close relationship with cerebral palsy (CP) development. Our aim was to investigate the roles of EPO and inflammatory cytokines in CP development. Serum samples of 31 CP patients (mean age 5.2 years, range 0 to 10 years), 37 neonates who suffered asphyxia and/or infection (mean age 6.3 days, range 0 to 19 days) and 40 controls (mean age 4.8 years, range 0 to 10 years) were obtained and kept at -40°C until assayed. EPO, tumour necrosis factor α (TNF-α) and interleukin 6 (IL-6) levels were measured by an enzyme-linked immunosorbent assay double sandwich method (ABC-ELISA). The EPO levels in serum of neonatal patients were higher than in the control group or CP group. There was no difference between the CP group and control group with regard to serum EPO levels. The TNF-α and IL-6 levels in serum of CP and neonatal patients were higher than in the control group. The serum TNF-α levels of the CP group were higher than in neonatal patients. There was no difference between CP group and neonatal patients with regard to serum IL-6 levels. The “waterfall” immune inflammatory responses mediated by proinflammatory cytokines gain the upper hand in brain damage against the protective effect mediated by EPO. This may lead to CP through triggering the cascading effect of the immune-neuroendocrine network.