Multicenter study for brain/body hypothermia for hypoxic–ischemic encephalopathy: Changes in<scp>HMGB</scp>‐1

Nakamura, Toshihiko; Asanuma, Hideomi; Kusuda, Satoshi; Imai, Ken; Hosono, Shigeharu; Kato, Reona; Suzuki, Satoshi; Yokoi, Kyoko; Kokubo, Minoru; Yamada, Shingo; Kamohara, Takashi

doi:10.1111/ped.13377

Cited by 9 publications

(6 citation statements)

References 22 publications

(65 reference statements)

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“…We have confirmed and reported in a multicenter cohort study that the effectiveness of brain hypothermia in neonatal asphyxia can be judged by changes in the serum high mobility group box-1 (HMGB-1) concentration [5]. Furthermore, we observed the serial changes of HMGB-1 in the blood of infants who had already developed fetal asphyxia and suffered severe sequelae even though brain hypothermia was started within 6 hours after birth.…”

Section: Introductionsupporting

confidence: 79%

"Circulating HMGB-1, HistoneH3, and Syndecan-1 in a Newborn with Neonatal Cerebral Infarction"

Nakamura¹

2021

BJSTR

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One of two late preterm twins at gestational age 36 weeks suffered idiopathic cerebral infarction. The first symptom was an apneic attack about 3 hours after birth. The lesion was extensive in the left middle cerebral artery region. Cord blood and early postnatal serum levels of high mobility group box-1 (HMGB-1), histoneH3, and syndecan-1 were measured simultaneously. All values of HMGB-1 remained within the reference value range. HMGB-1 and histoneH3 showed a very strong positive correlation (r=0.956). Syndecan-1 was detected but did not show a significant correlation with either HMGB-1 or histoneH3. This twin was delivered by Caesarean section before the first labor pains, and it was suspected that the ischemia-reperfusion injury that occurs at birth was minimal. Based on the serial changes of HMGB-1 in the early postnatal period, including in the umbilical cord blood, it is highly possible that the cerebral infarction had already occurred before birth. This case suggests that measurement of these three biomarkers released into the blood by ischemic reperfusion injuries such as stroke may be also useful for predicting these onsets.

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Section: Introductionsupporting

confidence: 79%

"Circulating HMGB-1, HistoneH3, and Syndecan-1 in a Newborn with Neonatal Cerebral Infarction"

Nakamura¹

2021

BJSTR

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“…Studies have shown that therapeutic hypothermia in neonatal HIE is effective to prevent long-term neurodevelopmental consequences [7][8][9][10][11] and results in fewer effects of organic injuries in newborns [7][8][9][10]. Although therapeutic hypothermia is used clinically to reduce neurological injury secondary to HIE, there remains a 45-55% risk of death or moderate to severe disability in treated infants [7,8,10].…”

Section: Benificial Effects Of Therapeutic Hypothermia Therapymentioning

confidence: 99%

“…The potential benefit of therapeutic hypothermia has increased pressure on clinicians to promptly and accurately assess neonatal HIE and the severity of the encephalopathy that may result [15]. Hypothermia therapy was also shown to improve function in organs other than the brain [7][8][9][10][11]16], exhibited lower mortality during first hospitalization [16], and lower hearing impairment in the hypothermia group compared with control infants [7,16].…”

Section: Benificial Effects Of Therapeutic Hypothermia Therapymentioning

confidence: 99%

Troponin I Levels in Neonatal Hypoxic–Ischemic Encephalopathy Are Related to Cardiopulmonary Comorbidity and Neurodevelopmental Outcomes

Lee

Wong

et al. 2021

JCM

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Troponin I is a biomarker for cardiac injury in children. The role of troponin I in neonatal Hypoxic–Ischemic encephalopathy (HIE) may have valuable clinical implications. Troponin I levels were measured within 6 h of birth to determine their relationship to HIE stage, short-term cardiac functional outcomes, and neurodevelopmental outcomes at 1 year. Seventy-three patients were divided into two groups: mild HIE and moderate to severe HIE. Troponin I levels within 6 h of birth were obtained in 61 patients, and were significantly higher in patients with moderate to severe HIE than in patients with mild HIE (Mann–Whitney U test, U = 146, p = 0.001). A troponin I cut-off level of ≥60 pg/mL predicted moderate to severe HIE with a specificity of 81.1% and a negative prediction rate of 76.9%. A troponin I cut-off level of ≥180 pg/mL was significantly (χ2 (1, n = 61) = 33.1, p = 0.001, odds ratio 96.8) related with hypotension during first admission and significantly (χ2 (1, n = 61) = 5.3, p = 0.021, odds ratio 4.53) related with abnormal neurodevelopmental outcomes at 1 year. Early troponin I level may be a useful biomarker for predicting moderate to severe HIE, and initialization of hypothermia therapy.

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“…Hypothermia as a rescue therapy for neonatal HIE is proven to be effective and to result in few adverse effects in newborns [ 5 , 6 , 7 ]. Although therapeutic hypothermia is employed to reduce neurological injury caused by HIE, a 45–55% risk of death or moderate or severe disability in treated infants remains [ 5 , 6 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Identifying Early Diagnostic Biomarkers Associated with Neonatal Hypoxic-Ischemic Encephalopathy

et al. 2021

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Background: Identifying an effective method for the early diagnosis of neonatal hypoxic-ischemic encephalopathy (HIE) would be beneficial for effective therapies. Methods: We studied blood biomarkers before 6 h after birth to correlate the degree of neonatal HIE. A total of 80 patients were divided into group 1 (mild HIE) and group 2 (moderate or severe HIE). Then, 42 patients from group 2 received hypothermia therapy and were further divided into group 3 (unremarkable or mild MRI results) and group 4 (severe MRI results). Results: Between groups 1 and 2, lactate, creatinine, white blood cells, and lactate dehydrogenase (LDH) were significantly different. Between groups 3 and 4, lactate, prothrombin time, and albumin were significantly different. Sarnat staging was based on our observation that more than 45 mg/dL of lactate combined with more than 1000 U/L of LDH yielded the highest positive predictive value (PPV) (95.7%; odds ratio, 22.00), but a low negative predictive value (NPV) for moderate or severe HIE. Using more than 45 mg/dL of lactate yielded the highest NPV (71.4%) correlated with moderate or severe HIE. Conclusions: Lactate combined with LDH before 6 h after birth yielded a high PPV. Using combined biomarkers to exclude mild HIE, include moderate or severe HIE, and initialize hypothermia therapy is feasible.

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Multicenter study for brain/body hypothermia for hypoxic–ischemic encephalopathy: Changes inHMGB‐1

Abstract: In HIE, HMGB-1 differs according to the presence of BHT, suggesting that HMGB-1 measurement soon after birth might be useful for determining BHT necessity and short-term outcome.

Cited by 9 publications

References 22 publications

"Circulating HMGB-1, HistoneH3, and Syndecan-1 in a Newborn with Neonatal Cerebral Infarction"

"Circulating HMGB-1, HistoneH3, and Syndecan-1 in a Newborn with Neonatal Cerebral Infarction"

Troponin I Levels in Neonatal Hypoxic–Ischemic Encephalopathy Are Related to Cardiopulmonary Comorbidity and Neurodevelopmental Outcomes

Identifying Early Diagnostic Biomarkers Associated with Neonatal Hypoxic-Ischemic Encephalopathy

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