The problem of ischemic brain damage among newborns is still relevant in the modern world. The frequency of occurrence of this pathology among full-term newborns remains at a fairly high level, both in Russia and abroad. Moreover, it has a high mortality rate and the percentage of early childhood disability is 60-70%, participating in the development of such diseases as minimal brain dysfunction, infantile cerebral palsy, epilepsy. According to the World Health Organization, about 20% of children suffer from neuropsychic disorders, whose causes in 65-80% of cases are perinatal brain lesions of hypoxic origin. The article deals with modern concepts of molecular genetic mechanisms of development of hypoxic-ischemic encephalopathy among newborns, as well as issues of classification and conditions under which this pathology develops. The author studied the latest domestic and foreign literature data on the properties and role of pro and anti-inflammatory cytokines, such as IL-1, IL-4, IL-6, IL-8, IL-10, IL-13, TNF-α, which are, according to modern concepts, one of the main links in the pathogenesis of ischemic brain injury. Also, special attention is paid to their genetic polymorphism, since qualitatively or quantitatively the genetically altered molecules of cytokines affect the immune response. Investigation of the level of cytokines and their genetic polymorphism before the onset of clinical symptoms will allow prediction the onset of the disease and preventing the adverse effects of the damage of the central nervous system.
Цель исследования: оценить биохимические маркеры повреждения головного мозга у доношенных новорожденных детей, перенесших внутриутробную гипоксию и/или асфиксию при рождении. Дизайн: ретроспективное когортное клиническое исследование. Материалы и методы. В исследование включены 142 доношенных новорожденных ребенка, которые были разделены на две группы: 1-я (основная) группа (n = 90)-дети, перенесшие внутриутробную гипоксию и/или асфиксию при рождении; 2-я (группа контроля) (n = 52)-дети, родившиеся с оценкой 8 баллов и выше по шкале Апгар и не испытавшие внутриутробную гипоксию. Проведены ретроспективный анализ историй развития новорожденных (течения беременности и родов у их матерей, особенностей раннего неонатального периода), а также оценка концентраций интерлейкинов (ИЛ-1β, ИЛ-4, ИЛ-6, ИЛ-8) и нейронспецифической енолазы (НСЕ) в сыворотке пуповинной крови. Результаты. Анализ концентраций интерлейкинов и НСЕ выявил статистически значимые различия между группами сравнения. Маркером перенесенных гипоксических событий явилось значимое повышение уровней НСЕ-9, 63 (6,71; 14,94)-и про-и противовоспалительных цитокинов: ИЛ-1β-8,5 (0,09; 36,39), ИЛ-6-14,11 (6,71; 141,0), ИЛ-8-50,4 (10,8; 182,7), ИЛ-4-0,90 (0,00; 3,84). Заключение. Диагностика поражений центральной нервной сиситемы должна основываться в том числе и на использовании лабораторных методов с оценкой маркеров, указывающих на патологический процесс. У детей с перенесенной внутриутробной гипоксией/асфиксией отмечаются повышенные уровни ИЛ-1β, ИЛ-6, ИЛ-8, ИЛ-4 и НСЕ, при этом некоторые дети основной группы не имели неврологической симптоматики и соответствующего диагноза. Ключевые слова: новорожденные дети, неврологическая симптоматика, асфиксия, внутриутробная гипоксия, интерлейкины, нейронспецифическая енолаза.
Pathology of the central nervous system (CNS) occupies one of the leading places in the structure of childhood morbidity and mortality. In the modern world the diagnosis of central nervous system diseases is based not only on the a thorough history, identification of certain neurological symptoms during an objective medical examination of the child and data from various neuroimaging methods, but also on the use of laboratory research methods with the identification of specific markers which indicate a pathological process occurring in the tissues of the brain and spinal cord. The article presents modern data on the biochemical parameters indicating damage to the nervous tissue, as well as their role in conditions of homeostasis and the prospects for further research. We analyzed the latest domestic and foreign literature on the properties and role of such indicators as neurotrophic growth factor, vascular endothelial growth factor, monocytic chemotactic protein, trigger receptor expressed on myeloid cells-1, trigger receptor expressed on myeloid cells-2, transforming growth factor, fractalkin, a nerve growth factor, which is a promising direction in the study of damage to nerve tissue. We can conclude that а study of the level of these markers will help diagnose the presence of damage to the nerve tissue, its severity, and therefore, select the right individual therapy for each specific child, thereby preventing the development of severe neurological consequences.
Background. An infant brain damage is an extremely urgent problem, this pathology is difficult to prevent, and subsequently it manifests itself with a variety of neurological consequences. Various mechanisms are involved in neurodamage; cytokines, as well as genes that control their activity, are under a great concern today. However, there is little data about their role as predictors of the brain damage among children after hypoxia. Aim of the research. To identify the frequency of cytokine gene polymorphism: interleukin (IL)-1β(C-511T), IL-1β(C3953T), IL-4(C589T), IL-6(C174G), IL-10(C819T), IL-10(G1082A) among newborns with hypoxic events. Materials and methods. The study involved 128 full-term newborn patients with hypoxic events: the first group (n = 48) included newborns who experienced chronic intrauterine hypoxia (CVH), the second group (n = 80) included newborns born in asphyxiation. Control group (52) included babies born without asphyxia and not suffering from CVH. A retrospective analysis of case-records was carried out. The material for molecular genetic analysis was DNA samples isolated from umbilical cord blood leukocytes using DNA Express Blood reagents (Scientific and Production Company LITECH, Moscow). Results. Compared to the control group (p = 0.03) children born in asphyxia had their T allele IL-1β (C-511T) prevailed. The group of newborn who had CVH had their TT genotype (p = 0.04) and the T IL-1β allele (C-511T) (p = 0.01) prevailed compared to the control group. In the same study group while studying the polymorphism of the IL-1β gene, the T allele (p = 0.03) at the point C3953T prevailed, in contrast to the control group. Conclusion. Due to the fact that cytokines are part of a reaction cascade leading to the secondary brain damage, under the action of hypoxia, it was found that among newborns undergoing asphyxia and chronic intrauterine hypoxia the increased frequencies of carriage of IL-1β-511TT and IL-1β-3953TT genotypes, and IL-1β-511T and IL-1β-3953T alleles increase the risk of neurodamage.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.