title: Serum amyloid A protein and hypoxic ischemic encephalopathy in the newborn.
abstract: OBJECTIVE
  Serum amyloid A (SAA) is an acute phase inflammatory marker that is closely associated with ischemic injuries. Its expression in neonatal hypoxic ischemic encephalopathy (HIE) has not been studied. To test the hypothesis that SAA is increased in neonatal HIE and its concentration correlates with the severity of encephalopathy.
  
  
  METHODS
  We conducted a prospective case-control study on 54 full-term neonates; 27 cases with evidence of perinatal compromise and 27 healthy controls. Blood samples were collected from cases and controls at postnatal day 1 and day 7, and SAA was measured by ELISA.
  
  
  RESULTS
  SAA concentrations (μg ml(-1)) were significantly increased in cases when compared with controls at day 1 and at day 7 (P<0.001). SAA concentrations at day 1 were greater in cases who died when compared with those who survived, and correlated significantly with the severity of HIE (146.9 ± 56.4 vs 79.8 ± 24.7 vs 58.1 ± 21.5) in severe, moderate and mild HIE, respectively (P=0.001).
  
  
  CONCLUSIONS
  The expression of SAA is increased in response to hypoxia ischemia of the neonate. The increased concentration correlates with the severity of encephalopathy and is associated with mortality. This is the first study of SAA in neonatal HIE.
authors.affiliation: Neonatology Division, The George Washington University & Children's National Medical Center, Washington, DC 20037, USA. haly@mfa.gw.edu
authors.forename: H
authors.initials: H
authors.lastname: Aly
authors.forename: Z
authors.initials: Z
authors.lastname: Hamed
authors.forename: L
authors.initials: L
authors.lastname: Mohsen
authors.forename: N
authors.initials: N
authors.lastname: Ramy
authors.forename: H
authors.initials: H
authors.lastname: Arnaoot
authors.forename: A
authors.initials: A
authors.lastname: Lotfy
mesh_terms: D000210:Acute-Phase Reaction / Q000097:blood* / Q000209:etiology; D001238:Asphyxia Neonatorum / Q000150:complications*; D015415:Biomarkers; D001921:Brain / Q000098:blood supply* / Q000473:pathology; D016022:Case-Control Studies; D003627:Data Interpretation, Statistical; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D007231:Infant, Newborn; D008991:Monitoring, Physiologic; D011446:Prospective Studies; D000685:Serum Amyloid A Protein / Q000032:analysis*; D012720:Severity of Illness Index; D047929:Term Birth
chemical_list: D015415:Biomarkers; D000685:Serum Amyloid A Protein