Abstract
Objective: Increased systemic inflammatory response during intrauterine period or period before the age of 3 is associated with cerebral palsy (CP) pathogenesis; however, effects of inflammatory processes involving mast cell activation in elder children with CP remain unclear. We aimed to investigate the role of mast cells and proinflammatory cytokines in children with CP at 3-18 years of age.
 Methods: In this cross-sectional study, venous blood samples were obtained from 30 volunteers with CP and 26 healthy volunteers at 3-18 years of age. Plasma levels of proinflammatory cytokines (IL-1β, IL-6 and IL-9) and mast cell biomarkers (histamine and tryptase beta-2) were determined using ELISA.
 Results: IL-1β, IL-6 and histamine levels were higher in individuals with CP compared to healthy controls. Likewise, IL-1β, IL-6, IL-9 and histamine levels were higher in the female patients with CP compared to the male patients, and in the female patients in adolescence compared to the female patients in pre-adolescence.
 Conclusion: Our findings indicate that the increased inflammatory response contributes to the pathogenesis of the disease in children with CP who are older than 2 years of age. Moreover the increased inflammatory response is more effective in female patients than in male patients, suggesting that there may be a gender difference in CP. Additionally mast cell activation contributes to the exacerbation of systemic inflammatory response in children with CP at 3-18 years of age.
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