Does Whole-Body Hypothermia in Neonates with Hypoxic–Ischemic Encephalopathy Affect Surfactant Disaturated-Phosphatidylcholine Kinetics?

Nespeca, Matteo; Giorgetti, Chiara; Nobile, Stefano; Ferrini, Ilaria; Simonato, Manuela; Verlato, Giuseppe; Cogo, Paola; Carnielli, Virgilio P.

doi:10.1371/journal.pone.0153328

Cited by 12 publications

(11 citation statements)

References 26 publications

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“…HIE is a neonatal brain injury disease characterized by changes in muscle tone or hypotension, convulsions and other clinical symptoms, and serious illness can lead to death in children (11). As one of the most effective methods for the treatment of HIE, sub-hypothermia treatment reduces the temperature of the body by 2–5°C, thereby reducing the level of adenosine triphosphate (ATP) in the brain cells and reducing lactic acid accumulation, which in turn reduces the levels of excitatory neurotransmitters, inflammatory mediators and other cytotoxins, so as to protect the nerves (12).…”

Section: Discussionmentioning

confidence: 99%

Effect of mild hypothermia on the expression of IL-10 and IL-18 in neonates with hypoxic ischemic encephalopathy

Liu

Yang

et al. 2019

Exp Ther Med

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The effect of mild hypothermia on the expression of interleukin (IL)-10 and IL-18 in neonates with hypoxic ischemic encephalopathy was investigated. A retrospective analysis was performed on 97 neonates with hypoxic-ischemic encephalopathy (HIE) admitted to the neonatal intensive care unit of Xuzhou Children's Hospital, Xuzhou Medical University from September 2016 to August 2018. Of these patients, 54 with mild hypothermia were included in the experimental group (moderate + severe), and 43 patients who received conventional therapy were included in the control group (moderate + severe). The effect of mild hypothermia on IL-10 and IL-18 expression levels was analyzed, and the relationship between IL-10, IL-18 and disease severity in children with hypoxic ischemic encephalopathy was analyzed. The concentration of IL-10 in the experimental group was significantly lower than that in the control group at 1, 2, 3 and 5 days (P<0.05). The concentration of IL-18 in the experimental group was significantly lower than that in the control group at the 2, 3 and 5 days (P<0.05). NBNA scores of the experimental group were significantly higher than those of the control group at 14 and 28 days after birth (P<0.05). Before treatment, the expression levels of IL-10 and IL-18 in severe children were significantly higher than those in moderate children (P<0.05). IL-10 was positively correlated with the severity of the disease (r=0.521, P<0.05), and IL-18 was also positively correlated with the severity of the disease (r=0.616 P<0.05). Mild hypothermia treatment can effectively improve the neurological function of children with HIE, reduce the expression of IL-10 and IL-18 in serum, and inhibit the inflammatory response. Therefore, the expression of IL-10 and IL-18 was positively correlated with the severity of disease in children with HIE, and could be used as an indicator to judge the severity of HIE.

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Section: Discussionmentioning

confidence: 99%

Effect of mild hypothermia on the expression of IL-10 and IL-18 in neonates with hypoxic ischemic encephalopathy

Liu

Yang

et al. 2019

Exp Ther Med

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“…The etiology of the MAS involves inflammatory response characterized by a predominantly neutrophilic infiltrate and stimulation of inflammatory cytokines (e.g., interleukin [IL]-1, IL-6, IL-8 and tumor necrosis factor [TNF]-α) [3][4][5] . The aim of MAS treatment focuses on minimizing ongoing injury, maintaining oxygenation, and reducing inflammation.…”

Section: ■ Introductionmentioning

confidence: 99%

Effects of hypothermia on lung inflammation in a rat model of meconium aspiration syndrome

2018

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1 2-Experimental SurgeryActa Cir Bras. 2018;33(6):483-490 AbstractPurpose: To evaluate the effects of hypothermia treatment on meconium-induced inflammation. Methods: Fifteen rats were instilled with human meconium (MEC, 1.5 mL/kg, 65 mg/mL) intratracheally and ventilated for 3 hours. Eight rats that were ventilated and not instilled with meconium served as a sham group. In MEC-hypothermia group, the body temperature was lowered to 33±0.5°C. Analysis of the blood gases, interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor (TNF)-α in bronchoalveolar lavage (BAL) fluid samples, and histological analyses of the lungs were performed. Results: The BAL fluid TNF-α, IL-1β, IL-6 and IL-8 concentrations were significantly higher in the MEC-hypothermia group than in the MEC-normothermia (p < 0.001, p < 0.001, p = 0.001, p < 0.001, respectively) and sham-controlled groups (p < 0.001, p < 0.001, p < 0.001, p < 0.001, respectively). Conclusion: Meconium-induced inflammatory cytokine production is affected by the body temperature control.

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“…Another possible explanation for the improvement in surfactant activity, is that hypothermia could stimulate the in vivo production or secretion of endogenous surfactant. However, DPPC pool and half-life have been reported to be unaffected by WBH [ 11 ]. Variations in other surfactant phospholipids or, alternatively, mobilization of surfactant components from pre-existing reservoirs could also play a role.…”

Section: Discussionmentioning

confidence: 99%

“…However, D9-choline labeling of healthy volunteers showed that upper airways samples still reflect alveolar PC composition and metabolism [ 41 ]. The fibroscopic technique is not suitable in neonates due to the small patients’ size and studies on neonatal lung biology are commonly done with the non-bronchoscopic BAL [ 9 , 11 , 25 , 28 ]. Moreover, our technique for non-bronchoscopic BAL is standardized and is known to describe the alveolar milieu better than the simple tracheal aspirates [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, the effect of WBH on the lung might be more complex, as it could theoretically affect surfactant function, as well. In fact, according to the scanty data available on this topic: 1) WBH seems to change surfactant adsorption overtime and reduce lung inflammation [ 8 , 9 ]; 2) in vivo metabolic replacement of disaturated-phosphatidylcholine (DPPC) does not change during WBH [ 11 ]; 3) animal and in vitro studies show that hypothermia may lead to changes in surfactant phospholipid composition [ 12 – 14 ]. These changes may be multifaceted and generate complex interactions.…”

Section: Introductionmentioning

confidence: 99%

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Controlled hypothermia may improve surfactant function in asphyxiated neonates with or without meconium aspiration syndrome

et al. 2018

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BackgroundWhole-body hypothermia (WBH) is used to improve neurological outcomes in perinatal asphyxia. Recent studies suggested a beneficial effect of hypothermia for some types of acute respiratory failure. However, no data are available about the biophysical function of human surfactant during WBH. We investigated whether WBH improves surfactant biophysical properties in asphyxiated neonates with or without meconium aspiration syndrome (MAS).MethodsNon-bronchoscopic bronchoalveolar lavage (BAL) has been collected from 10 asphyxiated neonates (2 with MAS, 8 with no lung disease (NLD)) at different time-points (pre-WBH, 24h, 48h, 72h of WBH and post-WBH). Surfactant was extracted and tested by captive bubble surfactometry (CBS) in triplicate, at 37°C and 33.5°C, through initial adsorption and dynamic compression-expansion cycling. Phosphatidylcholine and cholesterol were assayed using enzymatic methods. Clinical data were recorded in real-time.ResultsMinimum surface tension under dynamic testing was significantly improved as assessed at 33.5°C compared with its behavior at 37°C in NLD neonates: the difference was evident after at least 72h of WBH and remained significant at 6h after rewarming (72h: p = 0.009; rewarming: p = 0.040). Similar results were obtained in MAS patients whose surfactant activity improved already at 48h of hypothermia. Total cholesterol showed a trend to increase at the first 24-48h of hypothermia in NLD patients. Conversely, hypothermia seemed to reduce the excess of exogenous cholesterol in MAS surfactant.ConclusionsSurfactant biophysical properties may improve after 48-72h of WBH in asphyxiated neonates and the improvement is maintained shortly after rewarming. Due to study limitations, further studies are warranted to better clarify the effects of hypothermia on surfactant activity.

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Does Whole-Body Hypothermia in Neonates with Hypoxic–Ischemic Encephalopathy Affect Surfactant Disaturated-Phosphatidylcholine Kinetics?

Cited by 12 publications

References 26 publications

Effect of mild hypothermia on the expression of IL-10 and IL-18 in neonates with hypoxic ischemic encephalopathy

Effect of mild hypothermia on the expression of IL-10 and IL-18 in neonates with hypoxic ischemic encephalopathy

Effects of hypothermia on lung inflammation in a rat model of meconium aspiration syndrome

Controlled hypothermia may improve surfactant function in asphyxiated neonates with or without meconium aspiration syndrome

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