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

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

doi:10.1515/jpm-2017-0354

Article

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

Uday P. Patil , Pradeep V. Mally and Elena V. Wachtel

Published/Copyright: July 3, 2018

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From the journal Journal of Perinatal Medicine Volume 46 Issue 8

Abstract

Background

Evaluation of newborns for hypoxic ischemic encephalopathy (HIE) includes laboratory and clinical parameters, as well as amplitude integrated electroencephalogram (aEEG). Based on qualifying criteria, selective head cooling (SHC) is initiated for infants with evidence of moderate to severe HIE. However, some newborns may not qualify for hypothermia therapy based on normal aEEG.

Objective

To compare levels of serum glial fibrillary acidic protein (GFAP), ubiquitin c-terminal hydrolase-1 (UCHL-1) protein and phosphorylated axonal neurofilament heavy chain (pNF-H), in newborns who met initial screening criteria for HIE but did not qualify for head cooling, to the levels in healthy newborns.

Study design

Newborns ≥36 weeks of gestational age at risk for HIE, who were evaluated but did not qualify for SHC from July 2013 through June 2014 at NYU Langone Medical Center and Bellevue Hospital center were enrolled. A control group included healthy newborns from the newborn nursery (NBN). Serum samples were collected between 24 and 48 h of life from both groups.

Results

There was no significant difference in the serum levels of GFAP, UCHL-1 protein and pNF-H between the two groups of infants.

Conclusion

Newborns at risk for HIE who met the initial criteria for head cooling but who were excluded based on normal aEEG did not show significant elevation of biomarkers of brain injury compared to healthy newborns. These findings may help to validate using aEEG as an additional evaluation criteria in cooling.

Keywords: Glial fibrillary acidic protein; hypoxic ischemic encephalopathy; newborn; phosphorylated axonal neurofilament heavy chain; therapeutic hypothermia; ubiquitin C-terminal hydrolase-1 protein

Corresponding author: Uday P. Patil, MD, Department of Pediatrics, Division of Neonatology, Icahn School of Medicine at Mount Sinai and Elmhurst Hospital Center, 79-01 Broadway, A7-34, Elmhurst, NY 11373, USA, Tel.: +718-334-5788, Fax: +718-334-1253

aFormerly: Department of Pediatrics, Division of Neonatology, New York University School of Medicine, New York, NY 10016, USA.

Acknowledgment

This study was funded by a research grant from the Beltzman Fellowship Research Fund in Neonatology. This grant supplied funds for bio-repository support needed for specimen processing, barcoding, storage and shipping.

Author’s statement
Conflict of interest: Authors state no conflict of interest.
Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.
Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

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Article note

This article was selected from submitted papers on the occasion of the 40^th Annual Scientific Meeting of The New York Perinatal Society, held on April 25, 2017.

Received: 2017-11-12

Accepted: 2018-03-06

Published Online: 2018-07-03

Published in Print: 2018-10-25

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https://doi.org/10.1515/jpm-2017-0354

Keywords for this article

Glial fibrillary acidic protein; hypoxic ischemic encephalopathy; newborn; phosphorylated axonal neurofilament heavy chain; therapeutic hypothermia; ubiquitin C-terminal hydrolase-1 protein