Magnesium Sulfate Increases Intracellular Magnesium Reducing Inflammatory Cytokine Release in Neonates

Problem Magnesium sulfate (MgSO4) exposure reduces the risk of cerebral palsy. As neonatal inflammatory cytokine levels strongly correlate with neurologic outcome, we hypothesize that MgSO4 decreases inflammatory cytokine production. Method of study We assessed the effect of MgSO4 on cellular magnesium levels, cytokine production, and release within THP-1 and cord blood mononuclear cells. Results MgSO4 exposure increased intracellular magnesium levels, reducing the frequency of THP-1 cells producing IL-1b, IL-8, and TNF-a following LPS stimulation. Significant reductions in the frequency of neonatal monocytes producing TNF-a (48%) and IL-6 (37%) were seen following LPS stimulation, and MgSO4 also significantly decreased the frequency of monocytes producing TNF-a (35%) under basal conditions. Decreased cytokine production was confirmed via ELISA, demonstrating a sustained effect and dose response. Magnesium also reduced cytokine production following stimulation with TLR ligands representing obstetrical infections (group B Streptococcus and Mycoplasma) and in preterm neonatal monocytes. Conclusion MgSO4 increases intracellular magnesium, reducing inflammatory cytokine production and release, potentially elucidating the mechanism by which MgSO4 prevents cerebral palsy, eclampsia, and preterm birth.