The role of mast cells and pro-inflammatory cytokines in the course of disease in children with cerebral palsy

Cerebral palsy is one of the disabling diseases characterized by permanent brain injury. It is known that inflammation is implicated in the pathogenetic cascade of cerebral palsy before intrauterine or 3 years of age but, effects of inflammatory processes on the course of disease in childhood above the age of 3 years are unclear. We investigated the relationship between inflammatory process and the course of disease in childhood above the age of 3 years in children with cerebral palsy. Thirty cerebral palsy patients and 26 healthy volunteers aged 3-18 years were included in this study. Levels of proinflammatory cytokines IL-1β, IL-6 ve IL-9 and also markers of mast cell numbers and activation tryptase beta-2 and histamine in venous blood samples from the volunteers were measured using ELISA. Data were compared by Mann-Whitney U test. While circulating levels of IL-1β, IL-6 and histamine were higher in patients with cerebral palsy than that in control (p<0.05), there was no significant difference between the groups for IL-9 and tryptase beta-2 levels (p>0.05). IL-1β and IL-6 levels were higher in female patients than that in female and male in control group (p<0.05), moreover IL-9 levels were higher in female patients than that in female in control (p<0.05). IL-6 levels were higher in preadolescence patients than that in control (p<0.05). IL-1β, IL-6 and IL-9 levels were higher in preadolescence female patients than that in both preadolescence and adolescence female control (p<0.05). Our findings demonstrate that increased inflammation including mast cell activation is involved in the course of cerebral palsy. This increased inflammatory response is more potent in female patients, and tends to decrease during adolescent period. The increased level of anti-inflammatory estrogens in adolescent may be responsible for the decrease in the inflammatory response in female patients.