Biochemical markers of perinatal brain damage.
Hypoxia-ischemia constitutes a risk in infants by altering cerebral blood flow regulatory mechanisms and causing loss of cerebral vascular auto-regulation. Hypotension, cerebral ischemia, and reperfusion are the main events involved in vascular auto-regulation leading to cell death and tissue damage. These dramatic phenomena represent a common repertoire in infants complicated by perinatal acute or chronic hypoxia. To date, despite accurate perinatal and intra-operative monitoring, the post-insult period is crucial, since clinical symptoms and monitoring parameters may be of no avail and therapeutic window for pharmacological intervention (6-12 hours) may be limited, at a time when brain damage is already occurring. Therefore, the measurement of circulating biochemical markers of brain damage, such as vasoactive agents and nervous tissue peptides is eagerly awaited in clinical practice to detect high risk infants. The present review is aimed at investigating the role as circulating biochemical markers such as adrenomedullin, S100B, activin A, neuronal specific enolase (NSE), glial fibrillary acid protein (GFAP), in the cascade of events leading to ischemia reperfusion injury in infants complicated by perinatal asphyxia.
Florio
Pasquale
P
Department of Pediatrics, University of Siena, Siena, Italy.
Abella
Raul
R
Marinoni
Emanuela
E
Di Iorio
Romolo
R
Li Volti
Giovanni
G
Galvano
Fabio
F
Pongiglione
Giacomo
G
Frigiola
Alessandro
A
Pinzauti
Serena
S
Petraglia
Felice
F
Gazzolo
Diego
D
D028341:Activins; D053607:Adrenomedullin; D001238:Asphyxia Neonatorum / Q000150:complications* / Q000453:epidemiology; D015415:Biomarkers / Q000378:metabolism*; D001921:Brain / Q000378:metabolism*; D002352:Carrier Proteins; D006801:Humans; D002534:Hypoxia, Brain / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D007231:Infant, Newborn; D008895:Milk, Human / Q000737:chemistry; D009414:Nerve Growth Factors; D010100:Oxygen / Q000378:metabolism; D015427:Reperfusion Injury / Q000175:diagnosis / Q000378:metabolism*; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; D019265:Spectroscopy, Near-Infrared / Q000379:methods
D015415:Biomarkers; D002352:Carrier Proteins; C533270:NSMCE1 protein, human; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C579160:S100B protein, human; C422405:activin A; D028341:Activins; D053607:Adrenomedullin; D010100:Oxygen