Serum biomarkers of neuronal injury in newborns evaluated for selective head cooling: a comparative pilot study

Patil, Uday; Mally, Pradeep; Wachtel, Elena V.

doi:10.1515/jpm-2017-0354

Cited by 5 publications

(6 citation statements)

References 37 publications

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“…The results of our study are partly consistent with the previous studies in which GFAP levels in cord blood were not significantly higher in infants with HIE stage II-III compared with healthy controls ( 7 , 24 ). A recent study showed no difference in serum GFAP between infants at high risk for HIE and controls ( 24 ).…”

Section: Discussionsupporting

confidence: 93%

No increase in GFAP and S-100B in very preterm infants with mild periventricular leukomalacia or intraventricular hemorrhage: a pilot study

et al. 2022

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Aim To determine the serum levels of glial fibrillary acidic protein (GFAP) and S-100B in very preterm infants with and without periventricular leukomalacia (PVL) and/or intraventricular hemorrhage (IVH). Methods The study enrolled preterm infants born between 23 and 32 weeks of gestation admitted to the Neonatal Intensive Care Unit, University Medical Center Ljubljana. PVL and IVH were determined with cranial ultrasound. Peripheral blood was collected in the first 24 hours after delivery and once between days 4 to 7. GFAP and S-100B concentrations were measured in serum samples. Infants with PVL or IVH were compared with infants without PVL or IVH. Results Of 40 patients (mean gestational age 29.4 weeks), 7 had IVH and/or PVL. S-100B was detectable in peripheral blood in all patients at every measurement. In the group with IVH or PVL, the median S-100B at the first sampling was 0.43 (IQR 0.29-0.60) ng/mL, and 0.40 (IQR 0.33-1.01) ng/mL at the second sampling. In the group without PVL or IVH, it was 0.40 (IQR 0.29-0.6) ng/mL at the first sampling and 0.43 (IQR 0.34-0.62) ng/mL at the second sampling. The median GFAP was 0 regardless of the group and sampling time. The groups did not significantly differ in serum GFAP or S-100B levels. Conclusion Peripheral blood levels of GFAP and S-100B were not significantly increased in very preterm infants that developed PVL or IVH. The predictive value of GFAP and S-100B as biomarkers of neonatal brain injury should be further explored in a larger cohort of neonates with more extensive IVH or PVL.

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Section: Discussionsupporting

confidence: 93%

No increase in GFAP and S-100B in very preterm infants with mild periventricular leukomalacia or intraventricular hemorrhage: a pilot study

et al. 2022

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“…More recently, Patil et al measured GFAP in a cohort of PA infants potentially suitable for HT. They found a significant correlation between increased GFAP levels and the occurrence of abnormal aEEG [146].…”

Section: Bloodmentioning

confidence: 96%

“…More recently, Patil et al measured UCH-L1 in a cohort of PA infants potentially suitable for HT. They found high UCH-L1 in PA infants with abnormal aEEG subjected to HT and normal levels in PA infants with normal aEEG [146].…”

Section: Bloodmentioning

confidence: 96%

Early predictors of perinatal brain damage: the role of neurobiomarkers

Bersani

Pluchinotta

Dotta

et al. 2019

Clinical Chemistry and Laboratory Medicine (CCLM)

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The early detection of perinatal brain damage in preterm and term newborns (i.e. intraventricular hemorrhage, periventricular leukomalacia and perinatal asphyxia) still constitute an unsolved issue. To date, despite technological improvement in standard perinatal monitoring procedures, decreasing the incidence of perinatal mortality, the perinatal morbidity pattern has a flat trend. Against this background, the measurement of brain constituents could be particularly useful in the early detection of cases at risk for short-/long-term brain injury. On this scenario, the main European and US international health-care institutions promoted perinatal clinical and experimental neuroprotection research projects aimed at validating and including a panel of biomarkers in the clinical guidelines. Although this is a promising attempt, there are several limitations that do not allow biomarkers to be included in standard monitoring procedures. The main limitations are: (i) the heterogeneity of neurological complications in the perinatal period, (ii) the small cohort sizes, (iii) the lack of multicenter investigations, (iv) the different techniques for neurobiomarkers assessment, (iv) the lack of consensus for the validation of assays in biological fluids such as urine and saliva, and (v), the lack of reference curves according to measurement technique and biological fluid. In the present review we offer an up-to-date overview of the most promising developments in the use of biomarkers in the perinatal period such as calcium binding proteins (S100B protein), vasoactive agents (adrenomedullin), brain biomarkers (activin A, neuron specific enolase, glial fibrillary acidic protein, ubiquitin carboxyl-terminal hydrolase-L1) and oxidative stress markers.

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“…Like tau protein, its expression is increased after brain trauma in adult and pediatric patients. However, overall, recent neonatal evidence on outcome prediction has been disappointing [42][43][44].…”

Section: Tau Protein Ubiquitin C-terminal Hydrolase L1 and Oxidative ...mentioning

confidence: 99%

“…By contrast, there was no difference in cord blood GFAP levels within 3 h of birth between infants born with perinatal asphyxia and NE ( n = 86) and infants who had uncomplicated births ( n = 83) [42, 56]. Serum GFAP concentration also was not predictive in infants with NE before (<6 h of life) or during TH, or in NE infants who did not qualify for TH [41, 43, 57]. Overall, these findings suggest that in isolation serum GFAP is not a reliable marker for guiding treatment or prognosis after NE.…”

Section: Neurobiochemical Markersmentioning

confidence: 99%

Prognostic Neurobiomarkers in Neonatal Encephalopathy

Wassink¹,

Harrison²,

Dhillon³

et al. 2022

Dev Neurosci

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Therapeutic hypothermia is now standard-care for infants with moderate-severe neonatal encephalopathy (NE), and improves brain damage on neuroimaging, and neurodevelopmental outcomes. Critically, for effective neuroprotection, hypothermia should be started within 6 h from birth. There is compelling evidence to suggest that a proportion of infants with mild NE have material risk of developing brain damage and poor outcomes. This cohort is increasingly being offered therapeutic hypothermia, despite lack of trial evidence for its benefit. In current practice, infants need to be diagnosed within 6 h of birth for therapeutic treatment, compared to retrospective NE grading in the pre-hypothermia era. This presents challenges as NE is a dynamic brain disorder that can worsen or resolve over time. Neurological symptoms of NE can be difficult to discern in the first few hours after birth, and confounded by analgesics and anesthetic treatment. Using current enrolment criteria, a significant number of infants with NE that would benefit from hypothermia are not treated, and vice versa, infants are receiving mild hypothermia when its benefit will be limited. Better biomarkers are needed to further improve management and treatment of these neonates. In the present review, we examine the latest research, and highlight a central limitation of most current biomarkers: that their predictive value is consistently greatest after most neuroprotective therapies are no longer effective.

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Serum biomarkers of neuronal injury in newborns evaluated for selective head cooling: a comparative pilot study

Cited by 5 publications

References 37 publications

No increase in GFAP and S-100B in very preterm infants with mild periventricular leukomalacia or intraventricular hemorrhage: a pilot study

No increase in GFAP and S-100B in very preterm infants with mild periventricular leukomalacia or intraventricular hemorrhage: a pilot study

Early predictors of perinatal brain damage: the role of neurobiomarkers

Prognostic Neurobiomarkers in Neonatal Encephalopathy

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