Serum glial fibrillary acidic protein as a biomarker of brain injury in premature neonates

Neonatal brain injury is a serious adverse outcome of prematurity. Early detection of high risk premature neonates to develop neonatal brain injury is not currently feasible. The predictive value of many biomarkers has been tested, but none is used currently in clinical practice. The purpose of this study was to determine the levels and predictive value of serum glial fibrillary acidic protein (GFAP) in a prospective longitudinal case-control study during the first three days of life in premature neonates (<34 weeks of gestation) that later developed either intraventricular hemorrhage or periventricular leukomalacia. Each case (n=29) was matched according to birth weight and gestational age to one neonate with normal head ultrasound scans. No significant difference on GFAP levels was observed between the groups. Nevertheless, neonates with brain injury presented more frequently GFAP levels above the lowest detection limit (0.056 ng/ml) and this trend was significantly different during all days. The effectiveness of GFAP as an early biomarker of neonatal brain injury in premature neonates seems to be limited.

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Serum Activin A as Brain Injury Biomarker in the First Three Days of Life. A Prospective Case—Control Longitudinal Study in Human Premature Neonates

Brain Sciences ◽

10.3390/brainsci11091243 ◽

2021 ◽

Vol 11 (9) ◽

pp. 1243

Author(s):

Dimitra Metallinou ◽

Grigorios Karampas ◽

Eleftheria Lazarou ◽

Nikoletta Iacovidou ◽

Panagiota Pervanidou ◽

...

Keyword(s):

Longitudinal Study ◽

Brain Injury ◽

Periventricular Leukomalacia ◽

Intraventricular Haemorrhage ◽

Tertiary Hospital ◽

Case Control ◽

Activin A ◽

Neonatal Brain ◽

Premature Neonates ◽

Normal Head

Disruption of normal intrauterine brain development is a significant consequence of premature birth and may lead to serious complications, such as neonatal brain injury (NBI). This prospective case-control longitudinal study aimed at determining the levels and prognostic value of serum activin A during the first three days of life in human premature neonates which later developed NBI. It was conducted in a single tertiary hospital and eligible participants were live-born premature (<34 weeks) neonates. Each case (n = 29) developed NBI in the form of an intraventricular haemorrhage, or periventricular leukomalacia, and was matched according to birth weight and gestational age to one neonate with normal head ultrasound scans. Serum activin A levels in both groups showed a stable concentration during the first three days of life as no difference was observed within the two groups from the first to the third day. Neonates diagnosed with NBI had significantly higher activin A levels during the first two days of life compared to control neonates and its levels correlated to the severity of NBI during the second and third day of life. Although serum activin A on the second day was the best predictor for neonates at risk to develop NBI, the overall predictive value was marginally fair (area under the ROC-curve 69.2%). Activin A, in combination with other biomarkers, may provide the first clinically useful panel for the early detection of premature neonates at high risk of NBI.

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Predictive value of glial fibrillary acidic protein for prognosis in patients with moderate and severe traumatic brain injury: a systematic review and meta-analysis

Critical Care ◽

10.1186/cc10905 ◽

2012 ◽

Vol 16 (S1) ◽

Cited By ~ 2

Author(s):

E Laroche ◽

AF Turgeon ◽

A Boutin ◽

E Mercier ◽

F Lauzier ◽

...

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Glial Fibrillary Acidic Protein ◽

Severe Traumatic Brain Injury ◽

Predictive Value ◽

Meta Analysis ◽

Acidic Protein

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Hyperoxia and neonatal brain injury

Neuropediatrics ◽

10.1055/s-2005-867946 ◽

2005 ◽

Vol 36 (02) ◽

Author(s):

U Felderhoff-Mueser ◽

AM Kaindl ◽

C Bührer ◽

H Ikonomidou

Keyword(s):

Brain Injury ◽

Neonatal Brain ◽

Neonatal Brain Injury

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HISTOLOGICAL INFLAMMATORY RESPONSES IN THE PLACENTA AND EARLY NEONATAL BRAIN INJURY

Pediatric and Developmental Pathology ◽

10.2350/07-08-0324 ◽

2006 ◽

Vol preprint (2008) ◽

pp. 1

Author(s):

Vincenzo Zanardo ◽

Stefania Vedovato ◽

Agnese Suppiej ◽

Daniele Trevisanuto ◽

Mauro Migliore ◽

...

Keyword(s):

Brain Injury ◽

Inflammatory Responses ◽

Neonatal Brain ◽

Neonatal Brain Injury

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Faculty Opinions recommendation of Human traumatic brain injury induces autoantibody response against glial fibrillary acidic protein and its breakdown products.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718326742.793539000 ◽

2017 ◽

Author(s):

W Dalton Dietrich

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Glial Fibrillary Acidic Protein ◽

Acidic Protein ◽

Autoantibody Response

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Drug delivery platforms for neonatal brain injury

Journal of Controlled Release ◽

10.1016/j.jconrel.2020.12.056 ◽

2021 ◽

Author(s):

Rukhmani Narayanamurthy ◽

Jung-Lynn Jonathan Yang ◽

Jerome Y. Yager ◽

Larry D. Unsworth

Keyword(s):

Drug Delivery ◽

Brain Injury ◽

Neonatal Brain ◽

Neonatal Brain Injury

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PREDICTIVE VALUE OF LOW AT III LEVELS FOR THE OCCURRENCE OF IVH, IRDS AND DEATH IN PREMATURE NEONATES

10.1055/s-0038-1644268 ◽

1987 ◽

Author(s):

W van den Berg ◽

M Peters ◽

C Breederveld ◽

J W ten Cate ◽

J G Koppe

Keyword(s):

Positive Predictive Value ◽

Predictive Value ◽

Distress Syndrome ◽

Peripheral Vein ◽

Premature Neonates ◽

Significant Difference ◽

At Iii ◽

Diffuse Intravascular Coagulation ◽

Idiopathic Respiratory Distress Syndrome ◽

A Prospective Study

The observation of AT III deficiency in premature neonates with Idiopathic Respiratory Distress Syndrome (IRDS), suggests a positive predictive value for a poor outcome. The underlying diffuse intravascular coagulation could generate serious hemorrhagic complications like Peri/Intraventricular Hemorrhage (IVH).A prospective study was performed in consecutively born neonates to assess the predictive value of low AT III for theoccurrence of IVH, (gr. III/IV), IRDS, and death. Eighty-one neonates were included in the study during a period of 5 months. AT III levels were determined immediately after birth by a chromogenic substrate assay. Values in umbilical cord blood were identical with values in capillary or peripheral vein blood samples taken within 6 hours after birth. There was no correlation between AT III values and gestational age (r: 0.18). Twenty-four neonates with IRDS showed a mean AT III value of 0.23 U/ml (S. D. ± 0.07 U/ml) which was significantly lower than a mean AT III value of 0.35 U/ml (S. D. ± 0.1 U/ml) for neonates without IRDS (p ≺0.00005). When IVH gr. III/IV was diagnosed in neonates having IRDS (8/24) no significant difference in mean AT IIIact was observed with respect to jnean AT III levels of remaining neonates without this complication. No death occurred in neonates without IRDS. Mean AT IIIact (0.21 U/ml) in neonates with IRDS who died (9/24) was low compared with mean AT III levels of neonates with IRDS who survived (0.25 U/ml), but did not reach significance (p≻0.1). Assuming a critical value of AT III of 20% a positive predictive value of 89% for IRDS, 44% for IVH, and 56% for death was calculated. It is concluded that low AT Illact levels have a high predictive value for IRDS.

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