Serum Biomarkers of Cerebral Insult in Neonates with Hypoxic-ischemic Encephalopathy

Abstract

Background: Neonatal hypoxic-ischemic encephalopathy (NHIE) is one of the most common causes of fatality albeit the effort spent on the management. We aimed to measure the serum biomarkers of cerebral insult in neonates with hypoxic-ischemic encephalopathy and its correlation with treatment by erythropoietin (Epo). Methods: Serum biomarkers for brain injury were collected from neonates with NHIE at day zero and day five after affection. These biomarkers included brain-related proteins which included; ubiquitin carboxy-terminal hydrolase-L1 (UCH- L1), neuron enolase, Tau, and S100B. Furthermore, the study included different cytokines that can be traced in brain injury including; interleukins (ILs) 1b, 6, 8, 10, 12P70, and 13 in addition to tumor necrosis factor-alpha (NF-a), gamma interferon (IFN-g), monocyte chemoattractant protein-1, and brain-derived neurotrophic factor (BDNF). The brain injury was assessed by MRI after one year. Results: Among the included neonates, brain injury was associated with elevated baseline levels of ILs)1b, 6, 8, 10, and 13, IFN-g, TNF-a, Tau, UCH-L1, and S100B. Furthermore, elevated serum levels of Tau at the baseline and decreased level of BDNF at day five were correlated with a bad prognosis in one year. No correlation detected between Epo treatment and these biomarkers. Conclusions: The increased serum levels of the tested biomarkers at day zero were associated with brain insults in newborns with NHIE. Furthermore, BDNF and Tau were associated with worse prognosis, and there was no correlation detected between Epo treatment and these biomarkers.