title: Serum Hsp70 Antigen: Early Diagnosis Marker in Perinatal Asphyxia.
abstract: BACKGROUND
  Perinatal asphyxia is an important cause of mortality and permanent neurological and developmental deficit. Early and accurate diagnosis would help to establish the likely prognosis and may also help in determining the most appropriate treatment. Studies in experimental animal models suggest that a protein called Hsp70 may be a good and potentially useful marker of cellular stress that may be clinically useful in determining the presence of neonatal asphyxia.
  
  
  OBJECTIVE
  Regarding the importance of early and accurate diagnosis of asphyxia, we conducted this study, which is the first investigation of the comparison of the serum Hsp70 antigen level between asphyxiated and healthy infants.
  
  
  METHODS
  In this observational study, the serum concentrations of Hsp70 antigen were compared between neonates suffering from perinatal asphyxia (n = 50) and normal neonates (n = 51). The inclusion criteria for the cases were neonates who had reached term and had at least two clinical criteria of asphyxia. Exclusion criteria were babies with gestational age < 37 weeks, infants with congenital abnormalities or positive blood culture. Exclusion criteria in this group were the requirement to hospital stay during first week of the life or babies whose mothers had difficulties during pregnancy or delivery. Term neonates without major anomalies who had asphyxia during delivery were enrolled in the first six hours after delivery, and control group consisted of healthy term neonates without problems and normal delivery process in the first week of life. The cord blood was taken during labor to measure Hsp70 antigen level by using an in-house ELISA (The enzyme-linked immunosorbent assay).
  
  
  RESULTS
  The median values of serum anti Hsp70 titers were significantly higher in asphyxiated neonates compared with non-asphyxiated neonates (0.36 [0.04 - 1.14] vs 0.24 [0.01 - 0.63]). At cutoff point = 0.3125 ng/mL, sensitivity was 58% and specificity 76% based on ROC curve.
  
  
  CONCLUSIONS
  A significant difference between the serum concentrations of Hsp70 of the control and patient group was observed in this study. It is inferred serum concentrations of Hsp70 antigen may be a useful marker for the early diagnosis of that prenatal hypoxia.
authors.affiliation: Department of Pediatrics, Neonatal Research Center, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Boskabadi
authors.affiliation: Department of Pediatrics, Neonatal Research Center, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Omidian
authors.affiliation: Biochemistry and Nutrition Research Center, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran ; Cardiovascular Research Center, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran.
authors.forename: Shima
authors.initials: S
authors.lastname: Tavallai
authors.affiliation: Department of Basic Sciences, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, IR Iran ; Neurogenic Inflammation Research Center, School of Medicine, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran.
authors.forename: Shabnam
authors.initials: S
authors.lastname: Mohammadi
authors.affiliation: Biochemistry and Nutrition Research Center, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran ; Cardiovascular Research Center, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Parizadeh
authors.affiliation: Biochemistry and Nutrition Research Center, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran ; Cardiovascular Research Center, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Ghayour Mobarhan
authors.affiliation: Brighton and Sussex Medical School, Mayfield House, Falmer, Brighton, UK.
authors.forename: Gordon Aa
authors.initials: GA
authors.lastname: Ferns
keywords: Asphyxia Neonatorum; HSP70 Heat-Shock Proteins; Hypoxia-Ischemia, Brain