title: Serum biomarkers of MRI brain injury in neonatal hypoxic ischemic encephalopathy treated with whole-body hypothermia: a pilot study.
abstract: OBJECTIVE
  To determine if candidate biomarkers, ubiquitin carboxyl-terminal esterase L1 and glial fibrillary acidic protein, are elevated in neonates with hypoxic ischemic encephalopathy who die or have severe MRI injury compared with surviving infants with minimal or no injury on brain MRI.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Level IIIC outborn neonatal ICU in a free-standing children's hospital.
  
  
  METHODS
  Term newborns with moderate-to-severe hypoxic ischemic encephalopathy referred for therapeutic hypothermia
  
  
  METHODS
  Serum specimens were collected at 0, 12, 24, and 72 hours of cooling. MRI was performed in surviving infants at target 7-10 days of life and was scored by a pediatric neuroradiologist masked to biomarker and clinical data.
  
  
  RESULTS
  Serial biomarker levels were determined in 20 hypoxic ischemic encephalopathy patients. Ubiquitin carboxyl-terminal esterase L1 was higher at initiation and 72 hours of cooling, while glial fibrillary acidic protein was higher at 24 and 72 hours in babies with adverse outcome compared with those with favorable outcome.
  
  
  CONCLUSIONS
  This preliminary data support further studies to evaluate ubiquitin carboxyl-terminal esterase L1 and glial fibrillary acidic protein as immediate biomarkers of cerebral injury severity in newborns with hypoxic ischemic encephalopathy.
authors: Department of Neonatology, Children's National Medical Center, WA, USA. anguyenm@cnmc.org
authors: An N
authors: AN
authors: Massaro
authors: Andreas
authors: A
authors: Jeromin
authors: Nadja
authors: N
authors: Kadom
authors: Gilbert
authors: G
authors: Vezina
authors: Ronald L
authors: RL
authors: Hayes
authors: Kevin K W
authors: KK
authors: Wang
authors: Jackson
authors: J
authors: Streeter
authors: Michael V
authors: MV
authors: Johnston
mesh_terms: D015415:Biomarkers / Q000097:blood; D001930:Brain Injuries / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D005260:Female; D005904:Glial Fibrillary Acidic Protein / Q000097:blood*; D006801:Humans; D007036:Hypothermia, Induced; D020925:Hypoxia-Ischemia, Brain / Q000097:blood / Q000150:complications / Q000401:mortality / Q000628:therapy*; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index; D016896:Treatment Outcome; D043222:Ubiquitin Thiolesterase / Q000097:blood*
chemical_list: D015415:Biomarkers; D005904:Glial Fibrillary Acidic Protein; C482860:UCHL1 protein, human; D043222:Ubiquitin Thiolesterase
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