Detection and clinical significances of serum IL-18, Caspase-3 and S-100B protein expression level in neonatal hypoxic-ischemic encephalopathy

Abstract

Objective To analyze the levels and clinical significances of IL-18, Caspase-3 and nerve tissue-specific protein S-100B at different disease extent and different stages of infants with hypoxic-ischemic encephalopathy (HIE). Methods This study was clinical experimental studies.Sixty-seven infants with HIE (23 cases of mild HIE, 23 cases of moderate HIE, 21 cases of severe HIE) from February 2008 to June 2009 in Hebei Children′s Hospital were enrolled.The levels of IL-18, Caspase-3 and S-100B protein in all samples were measured at acute phase (1 d，3 d) and recovery phase (7 d) by ELISA method.Twenty healthy full-term neonates were selected as the normal control group.Multi-factor analysis of variance and Pearson correlation test was used for statistical analysis. Results The levels of the three indicators in the moderate and severe group were higher than the normal control group.In the moderate group，IL-18 levels were（132.15±9.87），（150.31±15.04）and (87.91±9.93） ng/L，Caspase-3 levels were (5.79±0.64)，(7.36±1.57）and (3.79±0.61）μg/L，S-100B levels were（6.82±0.61）,（9.62±1.29）and（10.76±1.64） μg/L.In the severe group, IL-18 levels were（160.23±16.03），（189.86±18.32）and （107.35±13.02） ng/L；Caspase-3 levels were (6.86±1.02)，（9.54±1.43）and（5.25±0.71） μg/L；S-100B levels were（8.90±0.32），（12.54±0.89）and（13.53±0.75） μg/L.In the normal control group, IL-18 levels were (71.08±11.52)，(72.53±11.05) and (71.93±11.30) ng/L；Caspase-3 levels were(2.84±0.52)，(2.98±0.53) and (2.87±0.52) μg/L；S-100B levels were（1.50±0.25），（1.62±0.30）and（1.53±0.29） μg/L.IL-18 levels ,Caspase -3 levels and S-100B levels in severe group were higher than the moderate group and the mild group were higher than the mild group.IL-18 levels were (73.46±4.77)，(77.59±4.02) and (72.87±6.92) ng/L;Caspase-3 levels were (3.13±0.31)，(3.63±0.40) and (3.26±0.45) μg/L;S-100B levels were（3.68±0.40），（5.851±0.63）and（6.95±0.58）μg/L in the mild group.S-100B levels in the mild group were higher than that in the normal control group.The IL-18 and Caspase-3 levels were risen in the third day to the first day in the acute phase of the moderate group and severe group, decreased in the recovery phase.Serum S-100B protein levels in the acute and recovery phase increased gradually, and there was no correlation between the three indicators (r=0.321, 0.14, 0.48, P=0.438,0.974,0.911 respectively). Conclusions IL-18, Caspase-3 and S-100B were involved in the pathophysiological process of HIE. The levels were closely related to the severity and disease progression of HIE, the severer of the illness, and the higher of the levels.Dynamic monitoring the changes of the three indicators may contribute to an early diagnosis, condition monitoring and prognosis of HIE.（Chin J Lab Med,2014,37: 276-280） Key words: Hypoxia-ischemia, brain; Interleukin-18; Caspase 3