Changes in Cyclic Nucleotide Levels in Cerebrospinal Fluid of Patients with Neonatal Sepsis: Preliminary Study

Abstract

OBJECTIVES: Previous studies have shown that blood cyclic nucleotides levels may be altered during sepsis. In the present study, we attempted to investigate the relationship between cyclic nucleotides in cerebrospinal fluid (CSF) and neonatal sepsis, and the cyclic nucleotide levels of CSF in normal neonates in Taiwan. METHODS: Twenty-four neonates received lumbar puncture for CSF studies, including cyclic 3',5'-adenosine monophosphate (cAMP) and cyclic 3',5'-guanosine monophosphate (cGMP), due to suspected neonatal sepsis. They were divided into control and sepsis groups. RESULTS: cAMP and cGMP levels were found to markedly increase (p＜0.05) in preterm septic patients without meningitis compared with non-septic preterm neonates, although their CSF studies by routine criteria were normal. In neonates without sepsis, cAMP levels in preterm and term babies were 14.39±1.45 and 18.61±3.38 pmol/mL, respectively. cGMP levels in preterm and term babies were 9.64±2.56 and 11.20±1.68 pmol/mL, respectively. Both the cAMP and cGMP levels of CSF in the control group between preterm and term neonates showed no statistical significance in the present study. CONCLUSIONS: Preliminary results suggest that cAMP and cGMP are more-sensitive indicators for transient cellular metabolic disturbances in the preterm brain during sepsis but in the absence of meningitis. The preterm septic neonate with meningitis seemed to have a higher CSF cGMP level.