Hypoxic-ischemic Encephalopathy Newborns Research Articles

Neurosonographic Classification in Premature Infants Receiving Omega-3 Supplementation Using Convolutional Neural Networks.

This study focuses on developing a model for the precise determination of ultrasound image density and classification using convolutional neural networks (CNNs) for rapid, timely, and accurate identification of hypoxic-ischemic encephalopathy (HIE). Image density is measured by comparing two regions of interest on ultrasound images of the choroid plexus and brain parenchyma using the Delta E CIE76 value. These regions are then combined and serve as input to the CNN model for classification. The classification results of images into three groups (Normal, Moderate, and Intensive) demonstrate high model efficiency, with an overall accuracy of 88.56%, precision of 90% for Normal, 85% for Moderate, and 88% for Intensive. The overall F-measure is 88.40%, indicating a successful combination of accuracy and completeness in classification. This study is significant as it enables rapid and accurate identification of hypoxic-ischemic encephalopathy in newborns, which is crucial for the timely implementation of appropriate therapeutic measures and improving long-term outcomes for these patients. The application of such advanced techniques allows medical personnel to manage treatment more efficiently, reducing the risk of complications and improving the quality of care for newborns with HIE.

Perinatal risk factors for asphyxia and the occurrence of hypoxic-ischemic encephalopathy in newborns

Intranatal asphyxia and hypoxic-ischemic encephalopathy of newborns are caused by risk factors from both the mother and the fetus, which makes the pathophysiology of this condition extremely difficult. Data from the federal statistical observation form No. 32 for the Moscow region show minor changes in the number of chronic diseases, a burdened obstetric and gynecological history, as well as pathology during pregnancy and childbirth in pregnant women over 3 years Perinatal risk factors were significantly more common in newborns with severe intranatal asphyxia and HIE compared with a moderate degree who underwent a therapeutic hypothremia procedure. Complications during the birth process, surgical methods of rapid fetal extraction (vacuum extractor) were the causal factors of asphyxia. To a minor extent, the asphyxia of the newborn is affected by the untimely discharge of amniotic fluid.

Estimation of the brain temperature during the hypothermia treatment of hypoxic ischemic encephalopathy in newborns

In this work, actual temperature measurements taken during the hypothermia treatment of the hypoxic-ischemic encephalopathy of a newborn are used for the solution of a state estimation problem. The objective is to sequentially estimate the newborn brain temperature during the local cooling treatment, by the application of the Sampling Importance Resampling (SIR) algorithm of the particle filter. A procedure is also proposed in this work to obtain individual geometric models for each patient, by using the mass, length and perimeter of the head measured after birth. The heat transfer model considered the body divided into spherical or cylindrical elements, representing the head, thorax, abdomen, arms, and legs. The results revealed that the SIR algorithm was accurate for the estimation of the body temperature, not only at locations where measurements were available, but also in internal regions of great interest for the hypothermia treatment, such as the brain.

Altered resting-state functional connectivity in newborns with hypoxic ischemic encephalopathy assessed using high-density functional near-infrared spectroscopy

Hypoxic-ischemic encephalopathy (HIE) results from a lack of oxygen to the brain during the perinatal period. HIE can lead to mortality and various acute and long-term morbidities. Improved bedside monitoring methods are needed to identify biomarkers of brain health. Functional near-infrared spectroscopy (fNIRS) can assess resting-state functional connectivity (RSFC) at the bedside. We acquired resting-state fNIRS data from 21 neonates with HIE (postmenstrual age [PMA] = 39.96), in 19 neonates the scans were acquired post-therapeutic hypothermia (TH), and from 20 term-born healthy newborns (PMA = 39.93). Twelve HIE neonates also underwent resting-state functional magnetic resonance imaging (fMRI) post-TH. RSFC was calculated as correlation coefficients amongst the time courses for fNIRS and fMRI data, respectively. The fNIRS and fMRI RSFC maps were comparable. RSFC patterns were then measured with graph theory metrics and compared between HIE infants and healthy controls. HIE newborns showed significantly increased clustering coefficients, network efficiency and modularity compared to controls. Using a support vector machine algorithm, RSFC features demonstrated good performance in classifying the HIE and healthy newborns in separate groups. Our results indicate the utility of fNIRS-connectivity patterns as potential biomarkers for HIE and fNIRS as a new bedside tool for newborns with HIE.

Long-term neurodevelopmental effects of exclusively high cord lactate levels in term newborn

Introduction Cord arterial blood gas analysis (ABGA) results are used as diagnostic criteria for hypoxic-ischemic encephalopathy in newborns with suspected perinatal asphyxia. This study evaluated the effect of cord ABGA lactate level on the long-term neurodevelopment of newborns without any clinical signs of perinatal asphyxia. Methods This clinical observation study was designed among term babies born between 2018 and 2019 in our unit. Cases with a 5-min Apgar score <7 and signs of fetal distress in their antenatal follow-up were excluded. The cases (n = 1438) were divided into two groups those with high cord lactate levels (above 5 mmol/L, n = 92) and those with low lactate levels (below 2 mmol/L, n = 255). An Ages and Stages Questionnaire, Third Edition (ASQ-3) developmental screening questionnaire was sent to all parents. Patients with a chronological age between 24 and 42 months and for whom the parents fulfilled the questionnaire (low lactate group, n = 29, and high lactate group, n = 45) were evaluated. Results No difference was observed between the two groups in terms of demographic characteristics such as age (p = .1669), male gender (p = .906), mother’s working situation (p = .948), mother’s education level (p = .828), father’s education level (p = .507), and family’s total income (p = .642). Mean ACQ-3 developmental screening test scores were significantly lower in the high lactate group compared to the low lactate group concerning; fine motor (40 vs. 60, p = .001), problem-solving (50 vs. 60, p = .002), and personal social development (45 vs. 60, p = .003). No difference was observed in terms of communication and gross motor total scores. Discussion In general practice, routine cord ABGA is not generally recommended for patients with normal Apgar scores and no suspected hypoxia. However, in this study, we observed that cases with a normal 5-min Apgar score, no suspected perinatal asphyxia, and a cord lactate value of ≥5 fell behind their peers when evaluated with the ACQ-3 developmental screening questionnaire.

Prediction of outcome of hypoxic-ischemic encephalopathy in newborns undergoing therapeutic hypothermia using heart rate variability.

To assess the use of continuous heart rate variability (HRV) as a predictor of brain injury severity in newborns with moderate to severe HIE that undergo therapeutic hypothermia. Two cohorts of newborns (n1 = 55, n2 = 41) with moderate to severe hypoxic-ischemic encephalopathy previously treated with therapeutic hypothermia. HRV was characterized by root mean square in the short time scales (RMSS) during therapeutic hypothermia and through completion of rewarming. A logistic regression and Naïve Bayes models were developed to predict the MRI outcome of the infants using RMSS. The encephalopathy grade and gender were used as control variables. For both cohorts, the predicted outcomes were compared with the observed outcomes. Our algorithms were able to predict the outcomes with an area under the receiver operating characteristic curve of about 0.8. HRV assessed by RMSS can predict severity of brain injury in newborns with HIE.

EBNEO Commentary: Safety and efficacy of erythropoietin in neonates with hypoxic-ischaemic encephalopathy.

EBNEO Commentary: Safety and efficacy of erythropoietin in neonates with hypoxic-ischaemic encephalopathy.

Circ_0007706 downregulation ameliorates neonatal hypoxic ischemic encephalopathy via regulating the miR-579-3p/TRAF6 axis

BackgroundNeonatal hypoxic ischemic encephalopathy (HIE) is a main factor of neonatal death and permanent neurologic deficit. This study sought to investigate the functional role of hsa_circ_0007706 (circ_0007706) in modulating neonatal HIE. MethodsIn vitro HIE cell model was established in hBMVECs under the condition of oxygen‑glucose deprivation/reperfusion (OGD/R) treatment. qRT-PCR analysis was utilized for detecting the level of circ_0007706, microRNA-579–3p (miR-579–3p) and TNF receptor-associated factor 6 (TRAF6). RNase R treatment and Oligo (dT) 18 primers were employed to verify the features of circ_0007706, and nucleocytoplasmic separation was conducted for determining the location of circ_0007706. CCK-8 assay, EdU assay, and flow cytometry were carried out to measure cell proliferation and apoptosis, respectively. The protein expression of Bax, Bcl-2 and TRAF6 was detected using western blot. Meanwhile, the levels of the pro-inflammatory factors were determined via ELISA. SOD activity and MDA level were assessed via the respective kits. Besides, dual-luciferase reporter assay and RNA pull-down were used to identify the association between miR-579–3p and circ_0007706 or TRAF6. ResultsCirc_0007706 was elevated in HIE newborns and OGD/R cell model. Knockdown of circ_0007706 greatly alleviated OGD/R-induced injury, inflammatory response and oxidative stress. We found that miR-579–3p was a direct target of circ_0007706, and miR-579–3p inhibitor could reverse the impact of circ_0007706 knockdown on OGD/R-caused cell damage in hBMVECs. In addition, miR-579–3p directly interacted with TRAF6, and the protective effects of miR-579–3p on OGD/R-induced injury in hBMVECs were harbored by TRAF6 overexpression. Our data indicated that circ_0007706 knockdown could downregulate the expression of TRAF6 by sponging miR-579–3p in OGD/R-treated hBMVECs. ConclusionThis study demonstrated that circ_0007706 knockdown assuaged HIE-induced injury by decreasing TRAF6 expression via targeting miR-579–3p.

Hypothermia as a treatment option for hypoxic-ischemic encephalopathy in newborns – A literature review

Introduction and purpose: Neonatal asphyxia is a medical condition in which the neonate is not able to maintain sufficient respiratory function. The hypoxia may be caused by either an impaired respiratory activity of the neonate or an interruption of blood flow to the placenta in the period immediately before or during delivery, which resulted in inadequate oxygen perfusion to vital organs.&#x0D; Description of the state of knowledge: Hypoxic-ischaemic encephalopathy (HIE) is a form of perinatal hypoxia, occurring in newborns after the 35th week of gestation and presenting along with neurological disorders. In fact, it is a major cause of death and infant disability. The incidence of HIE is approximately 2-5 per 1000 live births. The standard recommended treatment for perinatal hypoxic-ischaemic encephalopathy is therapeutic hypothermia. There are two methods used: selective head cooling with moderate whole-body hypothermia (SHC) and whole-body hypothermia (WBC). In both cases, metabolism and neural tissue destruction are slowed down.&#x0D; Conclusions: Therapeutic hypothermia is a promising treatment option for neonatal encephalopathy. Thus, it decreases the risk of death and neurological deficits in the form of cerebral palsy, epilepsy and psychomotor retardation. Whole-body hypothermia appears to be a more successful method than selective head cooling, however more research is still needed.&#x0D;

The use of near-infrared spectroscopy in the acute phase of hypoxic-ischemic encephalopathy in newborns

Detection of new markers of renal hypoperfusion in full-term infants during therapeutic cooling in moderate or severe hypoxic-ischemic encephalopathy to prevent the progression of acute kidney injury (AKI). Aim. To evaluate the significance of using continuous peripheral NIRS monitoring in full-term infants with hypoxic-ischemic encephalopathy for early detection of renal hypoperfusion against the background of prophylactic use of methylxanthines. Materials and methods. A prospective randomized controlled trial was conducted from 2019 to 2022 on the basis of the Neonatal Intensive Care Department of the Zaporizhzhia Regional Clinical Children’s Hospital. We included 50 full-term infants who underwent a program of total therapeutic hypothermia for moderate or severe hypoxic-ischemic encephalopathy. The infants were divided into 2 groups, each receiving methylxanthine to prevent the progression of AKI. Continuous NIRS monitoring of renal and brain tissues was performed throughout the cooling phase and until the end of the warming period. The relationship between NIRS and the development of AKI, which was determined according to the modified neonatal scale KDIGO (2012) by increasing serum creatinine and decreasing urine output during the first 5 days, was studied. Results. NIRS monitoring revealed that changes in cerebral CrSO2 were observed somewhat earlier than renal RrSO2, as the kidneys were less susceptible to autoregulation and perfusion changes than the brain. The level of CrSO2 was identical in 2 groups and did not change after the administration of caffeine citrate or theophylline. The average peripheral renal saturation rates were slightly higher than CrSO2 and tended to increase during the observation period due to the development of renal reperfusion after hypoxia. While the level of renal oxygen extraction decreased. The results obtained indicated that the warming period was characterized by normalization of perfusion, increase in regional renal saturation and decrease in renal oxygen excretion. In general, acute kidney injury in stage I developed in 4 (8.00 %) newborns, and stage II – in 1 (2.00 %), which was equivalent in both study groups (P = 0.8009; U = 299.00). Instead, the other children had stage 0 – 45 (90.00 %). None of the neonates had stage III according to KDIGO (2012) and required renal replacement therapy. Conclusions. The combined use of methylxanthines and the maintenance of optimal postnatal hemodynamics through NIRS diagnostics are vital for the prevention and treatment of acute kidney injury in neonates with moderate or severe hypoxic-ischemic encephalopathy.

ROLE OF SERUM S-100B PROTEIN AND MRI IN PREDICTING THE NEUROLOGICAL OUTCOME AND SEQUELAE IN NEONATES ≥ 36 WEEKS WITH BIRTH ASPHYXIA.

A prompt diagnosis of neonatal hypoxic-ischemic encephalopathy (HIE) remains a clinical challenge. This study aimed at exploring the potential of Serum protein S100B as a biomarker for evaluating neonatal HIE in newborns with moderateto-severe hypoxic-ischemic encephalopathy. Blood samples were collected from neonates with mild, moderate, or severe HIE who were admitted to the Department of Neonatology, Madras Medical College (MMC), Chennai between September 2016 to March 2017. The plasma levels of S100 B protein were measured at different time points. Additionally, Neurodevelopmental outcomes were also studied using MRI in surviving infants (&gt; 2 weeks). Eighty-four neonates enrolled in the study had moderate (n = 37), severe (n = 13) and mild HIE (n= 36). At birth, serum protein S100 B increased with the severity of HIE (P &lt; .001), and remained elevated in neonates with moderate to severe HIE. Serum protein S100 B was greater up to 72 hours in moderate to severe vs mild HIE. The Elevated levels of S100B were associated with increased brain injury as studied by MRI. The study suggests S S100 B may serve as a potential biomarker for neonatal mild HIE (n=36), moderate (n=37) and severe (n=13) could be used for stratication at birth as elevated levels are correlated with the severity of HIE.

Predictive Value of Heat-Shock Protein Gene Expression on Severe Neonatal Hypoxic-Ischemic Encephalopathy

This study aims to evaluate significant gene expression in severe hypoxic ischemic encephalopathy (HIE) in newborns, which can be used as a predictable measure for high-risk HIE infants. The study prospectively recruited 77 inborn near-term or term HIE newborns between January 2018 and December 2020. We measured six different genes within 6 h of life among the HIE infants and compared the gene levels between the mild- and severe-HIE groups. Among these, 64 HIE infants (83.1%) did not receive therapeutic hypothermia (TH) because they were categorized as mild HIE, and the 13 remaining (16.9%) infants were categorized as ≥ moderate-HIE group and received TH. More abnormal MRI findings, seizure, and use of anti-convulsant were more found in the ≥ moderate = HIE group along with longer mechanical ventilation days and hospitalization. Heat-shock protein 70 family 1 A (HSPA1A) and serpin family H member 1 (SERPINH1) genes, which encode heat-shock protein (HSP) 70 and 47, respectively, were significantly elevated in the ≥ moderate-HIE, seizure, and abnormal MRI groups. HSP 70 and 47 were significantly elevated in the severe-HIE group, possibly playing protective roles in inhibiting exacerbated neuroinflammation and maintaining a cellular homeostasis. At 18–24 months, ≥ moderate-HIE group manifested a significant language delay.

Erythropoietin as a Neuroprotective Drug for Newborn Infants: Ten Years after the First Use.

Protective strategies against perinatal brain injury represent a major challenge for modern neonatology. Erythropoietin (Epo) enhances endogenous mechanisms of repair and angiogenesis. In order to analyse the newest evidence on the role of Epo in prematurity, hypoxic ischemic encephalopathy (HIE) and perinatal stroke, a critical review using 2020 PRISMA statement guidelines was conducted. This review uncovered 26 clinical trials examining the use of Epo for prematurity and brain injury-related outcomes. The effects of Epo on prematurity were analysed in 16 clinical trials. Erythropoietin was provided until 32–35 weeks of corrected postnatal age with a dosage between 500–3000 UI/kg/dose. Eight trials reported the Epo effects on HIE term newborn infants: Erythropoietin was administered in the first weeks of life, at different multiple doses between 250–2500 UI/kg/dose, as either an adjuvant therapy with hypothermia or a substitute for hypothermia. Two trials investigated Epo effects in perinatal stroke. Erythropoietin was administered at a dose of 1000 IU/kg for three days. No beneficial effect in improving morbidity was observed after Epo administration in perinatal stroke. A positive effect on neurodevelopmental outcome seems to occur when Epo is used as an adjuvant therapy with hypothermia in the HIE newborns. Administration of Epo in preterm infants still presents inconsistencies with regard to neurodevelopmental outcome. Clinical trials show significant differences mainly in target population and intervention scheme. The identification of specific markers and their temporal expression at different time of recovery after hypoxia-ischemia in neonates might be implemented to optimize the therapeutic scheme after hypoxic-ischemic injury in the developing brain. Additional studies on tailored regimes, accounting for the risk stratification of brain damage in newborns, are required.

Effects of Tissue Temperature and Injury on ADC during Therapeutic Hypothermia in Newborn Hypoxic-Ischemic Encephalopathy.

ADC changes are useful in detecting ischemic brain injury, but mechanisms other than tissue pathology may affect the kinetic movement and diffusion of water molecules. We aimed to determine the effects of brain temperature on the corresponding ADC in infants undergoing therapeutic hypothermia. Brain temperature and ADC values in the basal ganglia, thalamus, cortical GM, and WM were analyzed during and after therapeutic hypothermia. The study cohort was categorized as having no-injury or injury. Among infants without injury, the correlation between ADC values and temperature was analyzed using the Pearson correlation. Intrasubject comparison of ADC changes during and after therapeutic hypothermia were analyzed, excluding patients who had an MR image interval of >5 days to minimize the effects of injury evolution. Thirty-nine infants with hypoxic-ischemic encephalopathy were enrolled (23 no-injury; 16 injury). The median ADC was significantly lower during therapeutic hypothermia (837; interquartile range, 771-928, versus 906; interquartile range, 844-1032 ×10-6mm2/s; P < .001). There was no difference in the ADC between the no-injury and injury groups during therapeutic hypothermia (823; interquartile range, 782-868, versus 842; interquartile range, 770-1008 ×10-6mm2/s; P = .4). In the no-injury group, in which ADC is presumed least affected by the evolution of injury, the median ADC was significantly lower during therapeutic hypothermia (826; interquartile range, 771-866, versus 897; interquartile range, 846-936 ×10-6mm2/s; P < .001). There was a moderate correlation between temperature and ADC in the no-injury group (during therapeutic hypothermia: Spearman ρ, 0.48; P < .001; after therapeutic hypothermia: ρ, 0.4; P < .001). Aside from brain injury, reduced tissue temperature may also contribute to diffusion restriction on MR imaging in infants undergoing therapeutic hypothermia.

Mood disorders in children following neonatal hypoxic-ischemic encephalopathy

Few studies on the consequences following newborn hypoxic-ischemic encephalopathy (NHIE) assess the risk of mood disorders (MD), although these are prevalent after ischemic brain injury in adults. To study the presence of MD in children survivors of NHIE. 14 children survivors of NHIE treated with hypothermia and without cerebral palsy and 15 healthy children without perinatal complications were studied aged three to six years for developmental status (Ages and Stages Questionnaire 3 [ASQ-3]) and for socio-emotional status (Preschool Symptom Self-Report [PRESS] and Child Behavior Checklist [CBCL] 1.5-5 tests). Maternal depression was assessed using Montgomery-Asberg Depression Rating Scale (MADRS). Socio-economic factors such as parental educational level or monthly income were also studied. NHIE children did not present delay but scored worse than healthy children for all ASQ3 items. NHIE children showed higher scores than healthy children for PRESS as well as for anxious/depressive symptoms and aggressive behavior items of CBCL. In addition, in three NHIE children the CBCL anxious/depressive symptoms item score exceeded the cutoff value for frank pathology (P = 0.04 vs healthy children). There were no differences in the other CBCL items as well as in maternal MADRS or parental educational level or monthly income. Neither ASQ3 scores nor MADRS score or socio-economic factors correlated with PRESS or CBCL scores. In this exploratory study children survivors of NHIE showed increased risk of developing mood disturbances, in accordance with that reported for adults after brain ischemic insults. Considering the potential consequences, such a possibility warrants further research.

Роль нейронспецифической енолазы в патогенезе гипоксически-ишемической энцефалопатии у новорожденных детей

The literature data on the clinical and diagnostic significance of neuron-specific enolase in the development of hypoxic-ischemic encephalopathy in newborns are presented. The expediency of determining this marker in various variants of the disease course is shown. The study of the content of this neurospecific protein is valuable for diagnosing, monitoring and predicting the course and outcomes of hypoxic-ischemic encephalopathy.

Effects of COVID-19 pandemic period on neonatal mortality and morbidity

BackgroundCorona Virus Disease 2019 (COVID-19) in pregnant women has important impacts on perinatal and neonatal outcomes. However, there are a limited number of studies investigating the effect of the pandemic period on newborns. With this study, we aimed to determine the impact of the 2020 COVID-19 outbreak on prenatal care, obstetric outcomes, neonatal mortality and morbidity.MethodsThe retrospective results of patients hospitalized to the Tertiary Neonatal Intensive Care Unit between 1 March and 30 May 2020, the first peak period of the pandemic in our country, were compared with the data of the same period of the previous year.ResultsA total of 307 cases were included in our study. The mean gestational weeks of the neonates hospitalized in the Neonatal Intensive Care Unit during the COVID-19 period were higher than those in the control group (p: 0.003). During the pandemic period, an increase was found in the frequency of pregnant women presenting to obstetric emergency services in emergencies requiring acute intervention (p: 0.01). Compared to the control group, there was an increase in the number of infants with small for gestational age (SGA) diagnosis, 5th-minute Apgar score of <7, and newborns with a diagnosis of hypoxic-ischemic encephalopathy who were treated with hypothermia in the study group (p < 0.05). No difference was found in terms of maternal and neonatal mortality (p > 0.05).ConclusionsDuring the COVID-19 pandemic, it was shown that pregnant women disrupted their regular antenatal care, and more pregnant women were admitted to the obstetric emergency department with emergencies requiring acute intervention. This led to an increase in the number of cases diagnosed with SGA and hypoxic-ischemic encephalopathy in newborns. Our results will be useful for better management of current and future pandemic periods.

The expression and clinical value of ubiquitin carboxyl-terminal hydrolase L1 in the blood of neonates with hypoxic ischemic encephalopathy.

BackgroundNeonatal hypoxic ischemic encephalopathy (HIE) can result in mental retardation due to the associated brain damage. Early identification of brain injury is vital for the prevention and treatment of brain damage in neonates. This study investigated the expression levels of serum ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) in neonates with HIE and its correlation with brain damage.MethodsFrom January 2019 to December 2020, 56 cases of neonatal patients with HIE were selected as the observation group, and 60 cases of healthy newborns delivered in our hospital during the same period were selected as the control group. Blood samples were obtained from neonates and the serum expression of UCH-L1 was detected by enzyme-linked immunosorbent assays (ELISAs). The relationship between UCH-L1 and neonatal prognosis and clinical features was analyzed.ResultsCompared with the healthy control group, the serum levels of UCH-L1 in the observation group was significantly higher (2.28±1.21 vs. 0.81±0.39 ng/mL, P=0.000). Furthermore, at 6 hours after birth, the serum levels of UCH-L1 were significantly higher in neonates with moderate to severe HIE compared to patients with mild HIE (2.92±0.80 and 1.76±0.72 ng/mL, respectively, P=0.000). Pearson correlation analysis showed that the expression levels of UCH-L1 were negatively correlated with the development quotient (DQ), intelligence index (MI), and the Neonatal Behavioral Neurological Assessment (NBNA) score of HIE newborns (P<0.05).ConclusionsThe level of UCH-L1 protein expression is elevated in the serum of newborns with HIE, and this may have a certain clinical value in predicting the intelligence of children.

MicroRNA-410 serves as a candidate biomarker in hypoxic-ischemic encephalopathy newborns and provides neuroprotection in oxygen-glucose deprivation-injured PC12 and SH-SY5Y cells.

BackgroundMicroRNA‐410 (miR‐410) has been found to be deregulated in neonatal hypoxic‐ischemic encephalopathy (HIE). However, the clinical significance and biological function of miR‐410 remain largely elusive. This study aims to investigate the expression and diagnostic performance of miR‐410 in HIE newborns, and explores the neuroprotective effect of miR‐410 in an oxygen‐glucose deprivation (OGD)‐induced cell injury model.MethodsExpression of miR‐410 was examined using quantitative real‐time PCR, and its diagnostic performance was evaluated using a receiver operating characteristic analysis. We used OGD‐injured PC12 and SH‐SY5Y cells to construct an in vitro HIE model. The effect of miR‐410 on OGD‐induced cell injury was analyzed by assessing cell viability and apoptosis. Enzyme‐linked immunosorbent assay was used to evaluate inflammation in cell model. A target gene was assessed according to the luciferase reporter assay.ResultsSerum miR‐410 expression was significantly decreased in HIE newborns and OGD‐injured cell model. The reduced miR‐410 expression served as a biomarker for the diagnosis and progression of HIE. The OGD‐induced impaired cell viability, enhanced cell apoptosis, and activated neuroinflammation were abrogated by the overexpression of miR‐140 in both PC12 and SH‐SY5S cells. Regarding the mechanisms underlying the function of miR‐410, phosphatase and tensin homolog (PTEN) was proposed as a direct target of miR‐410.ConclusionAll data revealed that serum downregulated miR‐410 in HIE serves as candidate diagnostic biomarker, and that miR‐410 exerts a neuroprotective role in OGD‐injured cells by improving cell viability and inhibiting cell apoptosis through targeting PTEN.

Biomarkers of Hypoxic-Ischemic Encephalopathy in Newborns

Biomarkers are particles that are released from target organs during tissue hypoxia injury. Recognizing biomarkers released from the damaged brain helps physicians determine the extent of tissue damage and the use of protective techniques in clinical treatment. Previous studies revealed that biomarkers such as brain-specific proteins (neuron-specific enolase (NSE), S100B, ubiquitincarboxy-terminal hydrolase-L1, total Tau) and cytokines, including IL-6, IL-1β, IL-10, IL-13, interferon-gamma, TNF alpha and brain-derived neurotrophic factor are useful in diagnosing hypoxic-ischemic encephalopathy (HIE) and predicting nerve growth outcomes. However, optimal sensitivity and specificity of these biomarkers have not been achieved, which has limited their clinical application. This review focuses on biomarkers such as lactate, LDH, NRBC, NSE, S100B, GFAP, CPK-BB, IL-6, NPBI, UCHL-1. More sensitive and accurate instruments such as brain imaging (such as brain MRI), brain function (such as NIRS, aEEG), and long-term neuroassay should be used in the future to confirm biomarkers of neonatal brain damage.