title: Biomarkers of brain injury in foals with hypoxic-ischemic encephalopathy.
abstract: BACKGROUND
  Neonatal hypoxic-ischemic encephalopathy (NHIE) is a disease affecting newborn foals for which there is no antemortem diagnostic test.
  
  
  OBJECTIVE
  Ubiquitin C-terminal hydrolase 1 (UCHL1) and the phosphorylated axonal forms of neurofilament H (pNF-H) are markers of brain injury in foals with NHIE.
  
  
  METHODS
  Thirty-three foals with a clinical diagnosis consistent with NHIE and 17 healthy foals.
  
  
  METHODS
  Retrospective study. Concentrations of UCHL1 and pNF-H in plasma were measured by ELISA. The performance of the assays for the diagnosis of NHIE was assessed by receiver operating characteristic curve analysis. Concentrations of UCHL1 and pNF-H were measured throughout the brains of 2 healthy foals.
  
  
  RESULTS
  The diagnostic performance of UCHL1 (AUC = 0.86) was significantly higher (P = .001) than that of pNF-H (0.52) for the diagnosis of NHIE. Median concentrations of UCHL1 (6.57 ng/mL; 2.35-11.90 ng/mL) in foals with a clinical diagnosis of NHIE were significantly (P < .001) higher than those of healthy controls (2.52 ng/mL; 1.4-4.01 ng/mL). The right sided reference interval for UCHL1 concentrations in healthy foals was 0-4.01 ng/mL. The sensitivity and specificity of UCHL1 (>4.01 ng/mL) for diagnosis of NHIE were 70% (51-84%) and 94% (72-99%), respectively. UCHL1 concentrations were higher in gray than white matter, while pNF-H concentrations were higher in white than gray matter.
  
  
  CONCLUSIONS
  UCHL1 has potential as a marker of brain injury in foals with NHIE.
authors.affiliation: Countryside Equine Hospital, Louisville, TN, USA.
authors.forename: N C
authors.initials: NC
authors.lastname: Ringger
authors.forename: S
authors.initials: S
authors.lastname: Giguère
authors.forename: P R
authors.initials: PR
authors.lastname: Morresey
authors.forename: C
authors.initials: C
authors.lastname: Yang
authors.forename: G
authors.initials: G
authors.lastname: Shaw
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D015415:Biomarkers / Q000097:blood; D015153:Blotting, Western; D001930:Brain Injuries / Q000097:blood / Q000473:pathology / Q000662:veterinary*; D004797:Enzyme-Linked Immunosorbent Assay / Q000662:veterinary; D006734:Horse Diseases / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D006736:Horses; D020925:Hypoxia-Ischemia, Brain / Q000097:blood / Q000473:pathology / Q000662:veterinary*; D016900:Neurofilament Proteins / Q000097:blood*; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D043222:Ubiquitin Thiolesterase / Q000097:blood*
chemical_list: D015415:Biomarkers; D016900:Neurofilament Proteins; D043222:Ubiquitin Thiolesterase