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

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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S100B as a biomarker of brain injury in premature neonates. A prospective case – control longitudinal study

Clinica Chimica Acta ◽

10.1016/j.cca.2020.09.013 ◽

2020 ◽

Vol 510 ◽

pp. 781-786

Author(s):

Dimitra Metallinou ◽

Grigorios Karampas ◽

Georgia Nyktari ◽

Nikoletta Iacovidou ◽

Katerina Lykeridou ◽

...

Keyword(s):

Longitudinal Study ◽

Brain Injury ◽

Case Control ◽

Premature Neonates

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

Bosnian Journal of Basic Medical Sciences ◽

10.17305/bjbms.2021.6205 ◽

2021 ◽

Author(s):

Dimitra Metallinou ◽

Grigorios Karampas ◽

Georgia Nyktari ◽

Nicoletta Iacovidou ◽

Katerina Lykeridou ◽

...

Keyword(s):

Brain Injury ◽

Glial Fibrillary Acidic Protein ◽

Predictive Value ◽

Periventricular Leukomalacia ◽

Acidic Protein ◽

Neonatal Brain ◽

Premature Neonates ◽

Neonatal Brain Injury ◽

Significant Difference ◽

Prospective Longitudinal

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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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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Hypotension in Preterm Infants (HIP) randomised trial

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2020-320241 ◽

2021 ◽

pp. fetalneonatal-2020-320241

Author(s):

Eugene M Dempsey ◽

Keith J Barrington ◽

Neil Marlow ◽

Colm Patrick Finbarr O'Donnell ◽

Jan Miletin ◽

...

Keyword(s):

Brain Injury ◽

Primary Outcome ◽

Randomised Trial ◽

Intraventricular Haemorrhage ◽

Standard Group ◽

Double Blind ◽

Group Assignment ◽

Standard Management ◽

Postmenstrual Age ◽

Registration Number

ObjectiveTo determine whether restricting the use of inotrope after diagnosis of low blood pressure (BP) in the first 72 hours of life affects survival without significant brain injury at 36 weeks of postmenstrual age (PMA) in infants born before 28 weeks of gestation.DesignDouble-blind, placebo-controlled randomised trial. Caregivers were masked to group assignment.Setting10 sites across Europe and Canada.ParticipantsInfants born before 28 weeks of gestation were eligible if they had an invasive mean BP less than their gestational age that persisted for ≥15 min in the first 72 hours of life and a cerebral ultrasound free of significant (≥ grade 3) intraventricular haemorrhage.InterventionParticipants were randomly assigned to saline bolus followed by either a dopamine infusion (standard management) or placebo (5% dextrose) infusion (restrictive management).Primary outcomeSurvival to 36 weeks of PMA without severe brain injury.ResultsThe trial terminated early due to significant enrolment issues (7.7% of planned recruitment). 58 infants were enrolled between February 2015 and September 2017. The two groups were well matched for baseline variables. In the standard group, 18/29 (62%) achieved the primary outcome compared with 20/29 (69%) in the restrictive group (p=0.58). Additional treatments for low BP were used less frequently in the standard arm (11/29 (38%) vs 19/29 (66%), p=0.038).ConclusionThough this study lacked power, we did not detect major differences in clinical outcomes between standard or restrictive approach to treatment. These results will inform future studies in this area.Trial registration numberNCT01482559, EudraCT 2010-023988-17.

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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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The common antitussive agent dextromethorphan protects against hyperoxia-induced cell death in established in vivo and in vitro models of neonatal brain injury

Neuroscience ◽

10.1016/j.neuroscience.2014.05.059 ◽

2014 ◽

Vol 274 ◽

pp. 260-272 ◽

Cited By ~ 4

Author(s):

A. Posod ◽

K. Pinzer ◽

M. Urbanek ◽

K. Wegleiter ◽

M. Keller ◽

...

Keyword(s):

Cell Death ◽

Brain Injury ◽

In Vitro Models ◽

Neonatal Brain ◽

Neonatal Brain Injury ◽

The Common

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745 Risk Factors of Incident Renal Stones in Indian Population: A Hospital-Based Case-Control Study

British Journal of Surgery ◽

10.1093/bjs/znab134.573 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

S Singh ◽

S Gupta ◽

T S Mishra ◽

B D Banerjee ◽

T Sharma ◽

...

Keyword(s):

Risk Factors ◽

Heavy Metals ◽

Case Control Study ◽

Dietary Habits ◽

Renal Stones ◽

Tertiary Hospital ◽

Case Control ◽

The Body ◽

Increased Risk ◽

Control Study

Abstract Introduction Nephrolithiasis is pathological calcification in the excretory passages of the body and is prevalent among 7.6% of Indians. We aimed to study the various risk factors associated with renal stones from India. Method It was a hospital-based case-control study conducted over 18 months in a tertiary hospital in Delhi. Cases were defined as patients with renal stones diagnosed on the basis of history and radiological examination. Controls were similar to cases in all respects except for the diagnosis and selected from the hospital. A total of 18 risk factors, including age, gender, heavy metals, stress, metabolic factors, alcohol intake, dietary habits, co-morbidities, etc. were assessed. Logistic regression analysis was performed to calculate the strength of the risk associations. Results In the analysis of 60 cases and controls, we found 6 times, 5.5 times, and 2.4 times increased odds of renal stones in patients with increased arsenic, cadmium, and lead concentrations in blood, respectively. Similarly, there are 3 times increased odds of renal stones in patients suffering from stress. Conclusions Exposure to smoke, occupation dust, and contaminated water may lead to an increased ingestion/inhalation of heavy metals like cadmium, arsenic, and predisposing people to an increased risk of renal stones.

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