Expression of soluble Fas in the cerebrospinal fluid of preterm infants with posthemorrhagic hydrocephalus and cystic white matter damage

Thomas Schmitz, Ursula Felderhoff-Mueser 3 , Marco Sifringer 1 , Floris Groenendaal 4 , Susanne Kampmann 1  and Axel Heep 5
  • 1 Department of Neonatology, Charité Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin D-13353, Germany
  • 2 Children's National Medical Center, Center for Neuroscience Research, Washington, DC 20010, USA
  • 3 Department of Pediatrics I/Neonatology, University Hospital Essen, Essen 45122, Germany
  • 4 Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
  • 5 Department of Neonatology, Friedrich-Wilhelms University, Bonn 53113, Germany


Perinatal brain damage may result in impaired neurological development in extremely preterm infants. The underlying pathophysiological mechanisms are complex, and biomarkers of prognostic value are not available. The aim of this study was to analyze soluble Fas (sFas) concentrations in the cerebrospinal fluid (CSF) representative for involvement of apoptotic processes in preterm infants developing posthemorrhagic hydrocephalus (PHHC) and to link them to white matter damage (WMD) diagnosed by cranial ultrasound. A total of 29 preterm infants with PHHC were included in the study; 17 of them had signs of cystic WMD (cWMD) on ultrasound examinations. CSF samples were obtained at first ventriculostomy, and results were compared to those of a reference group of 24 preterm and term infants without neurologic diseases. sFas concentrations were elevated in CSF samples of PHHC patients compared to the reference group. In patients with cWMD, sFas concentrations were significantly higher than in patients without cWMD. These results indicate that apoptosis via the Fas pathway is involved in the pathogenesis of cWMD in the context of PHHC, and that sFas in the CSF may serve as a marker of cWMD development.

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The Journal of Perinatal Medicine is a truly international forum covering the entire field of perinatal medicine. It is an essential news source for all those obstetricians, neonatologists, perinatologists and allied health professionals who wish to keep abreast of progress in perinatal and related research.