ELEVATION OF TRANSFORMING GROWTH-FACTOR-BETA-1 LEVEL IN CEREBROSPINAL-FLUID OF PATIENTS WITH COMMUNICATING HYDROCEPHALUS AFTER SUBARACHNOID HEMORRHAGE

Background and Purpose Transforming growth factor-beta 1 (TGF-beta 1) is a multifunctional polypeptide that controls the production of extracellular matrix protein. Platelets store a large quantity of TGF-beta 1, which is released at hemorrhage. We recently reported that human recombinant TGF-beta 1 induced communicating hydrocephalus in mice. The aim of this study was to determine whether TGF-beta 1 is related to the development of communicating hydrocephalus after subarachnoid hemorrhage (SAH). Methods TGF-beta 1 in the cerebrospinal fluid of 24 patients with SAH was measured with enzyme-linked immunosorbent assay. The levels were compared between hydrocephalic and nonhydrocephalic groups. Western blot analysis was performed to determine active TGF-beta 1 in the cerebrospinal fluid. Results TGF-beta 1 rapidly decreased from the onset of SAH. The level of TGF-beta 1 of 13 patients showing ventricular dilatation with periventricular low density on computed tomographic scan was 1.07+/-0.37 ng/mL on days 12 through 14, which was significantly higher than 0.52+/-0.21 ng/mL in patients without ventricular dilatation (P<.02). Furthermore, the TGF-beta 1 level of patients who had undergone ventriculoperitoneal shunt (n=11) was 1.111+/-0.09 ng/mL on days 12 through 14, which was also higher than the level of the nonshunt group (n=13) (0.56+/-0.22 ng/mL; P<.01). A 25-kD band was demonstrated by Western blot analysis in the cerebrospinal fluid of a patient with SAH. Conclusions Our results strongly suggest that TGF-beta 1 plays an important role in generating communicating hydrocephalus after SAH.