Erythropoietin is present in the cerebrospinal fluid of neonates,☆☆,,★★

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Abstract

Erythropoietin (Epo) was measured by enzyme-linked immunosorbent assay in 80 cerebrospinal fluid (CSF) samples to determine whether Epo is present in the CSF of infants, CSF Epo concentrations correlate with age, and CSF Epo concentrations correlate with Epo therapy. Epo was present in the CSF of normal neonates. CSF Epo concentrations correlated negatively with increasing age. Recombinant Epo therapy did not affect CSF Epo concentrations, although values ranged somewhat higher in this group.

Section snippets

CSF specimens

Spinal fluid was obtained from 50 neonates ranging in gestational age from 24 weeks to term. Twenty-three of these neonates were treated with rEpo at the discretion of the attending neonatologist. Two neonates had meningitis and were considered separately. Thirty additional spinal fluid samples from patients aged 1 month to 60 years of age, none of whom were receiving rEpo treatment, were assayed. All samples were obtained from the clinical laboratory of Shands Teaching Hospital after patients

RESULTS

Epo was present in the spinal fluid of premature and term neonates in the absence of rEpo treatment, meningitis, or intracranial hemorrhage (Figure).

Figure. Epo concentrations in the spinal fluid of 80 subjects. Control individuals (no rEpo therapy) are identified by open circles , infants receiving treatment with rEpo are denoted by open triangles , and the two patients with meningitis (neither received rEpo) are shown by filled triangles . Erythropoietin concentrations are reported in

DISCUSSION

Epo is a 34,000-dalton glycoprotein that, on the basis of size, is unlikely to cross the blood-brain barrier in the absence of a carrier molecule. It is possible, however, that in the presence of an extremely immature blood-brain barrier, asphyxia, acidosis, or meningitis, or after an intraventricular hemorrhage, the blood-brain barrier might be more likely to permit the transfer of large molecules such as Epo. We observed that Epo was present in the CSF of normal preterm and term infants in

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From the Division of Neonatology, Department of Pediatrics, University of Florida College of Medicine, Gainesville.

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Supported by grants MCAP RR-00083 and HL-44951 from the National Institutes of Health and by a grant from the Children's Miracle Network.

Reprint requests: Sandra Juul, MD, Division of Neonatology, University of Florida College of Medicine, PO Box 100296, J. Hillis Miller Health Center, Gainesville, FL 32610-0296.

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