Brain-derived neurotrophic factor and neuroimaging in pediatric patients with sickle cell disease

Abstract

Background The risk of neurological complications is increased in children with sickle cell disease (SCD), such as silent cerebral infarction (SCI) and stroke. Brain-Derived Neurotrophic Factor (BDNF) is a nerve growth factor associated with elevated transcranial Doppler (TCD) velocities and increased risk of stroke in SCD patients. So, we assessed the BDNF level in children with SCD and its relation to neurological complication as silent stroke. Methods A comparative cross-sectional study was conducted on 40 patients with SCD, recruited from the Hematology Unit, Pediatric Department, Menoufia University Hospital, and 40 healthy children as controls. Laboratory investigations including BDNF were done. TCD was done for all patients and Magnetic Resonance Imaging (MRI) was done on high-risk patients. Results BDNF levels were significantly higher in children with SCD than in controls with a significant relation to TCD findings. There was a statistically significant diagnostic ability of BDNF in the prediction of SCD complications as its sensitivity was 89.5%, specificity (95% CI) was 80% with a cut-off point >0.69, AUC = 0.702, and p = 0.004). Conclusion Serum BDNF levels were higher in sickle disease patients who had abnormal transcranial Doppler. BDNF had a significant diagnostic ability in the detection of SCD complications. Impact Silent stroke is a very serious complication in children with sickle cell disease, so regular follow up should be every six months. BDNF is considered a potential biomarker for stroke risk prediction in patients unable to receive TCD.

Brain-Derived Neurotrophic Factor in Pediatric Acquired Brain Injury and Recovery

“…Consistent with the pediatric TBI and neurocritical care studies above, two studies involving pediatric stroke in children with sickle cell disease also found higher BDNF plasma concentrations acutely after brain injury compared to other children with sickle cell disease or healthy controls (n = 8 with stroke, n = 40 with stroke, respectively) [91]. Importantly, preclinical studies in rats report conflicting evidence regarding whether BDNF concentrations in the periphery mimic cortical concentrations after stroke, when the blood-brain barrier remains largely intact with ischemia [92,93].…”

Neurofilament light chain: A potential biomarker for cerebrovascular disease in children with sickle cell anaemia

“…A 2014 systematic review of associations between acute or pre‐existing paediatric SCA cerebrovascular injury and candidate blood biomarkers included growth factors, markers of inflammation, adhesion or thrombosis and GFAP 47 . More recently, neuregulin‐1b and two other plasma proteins not specific to the CNS were reported for elevated TCD velocity in paediatric SCA 48,49 . Future research should continue to perform multimarker evaluations and assess CNS specificity in this multisystem disease.…”

“…47 More recently, neuregulin-1b and two other plasma proteins not specific to the CNS were reported for elevated TCD velocity in paediatric SCA. 48,49 Future research should continue to perform multimarker evaluations and assess CNS specificity in this multisystem disease.…”