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[Biochemical parameters predictive of neuronal damage in childhood]
M Castro-Gago1, A Rodríguez-Núñez, M I Novo-Rodríguez
1Departamento de Pediatría; Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, 15706, España. pdcastro@uscmail.usc.es
Insights
Early detection of brain injury from hypoxia is crucial. This review examines biochemical markers like lactate and glial fibrillary acidic protein for diagnosing and predicting hypoxic ischemic encephalopathy in newborns.
Area of Science:
- Biochemistry
- Neuroscience
- Neonatal Medicine
Context:
- Hypoxemia, hypoxia, and ischemia can cause severe neuronal damage.
- Early assessment of hypoxic-ischemic encephalopathy (HIE) is vital for timely interventions.
- Understanding the physiopathology of HIE guides the search for reliable biomarkers.
Purpose:
- To review the diagnostic and prognostic value of biochemical markers in HIE.
- To evaluate various biomarkers studied in recent years.
- To focus on markers relevant to newborn hypoxic-ischemic brain injury.
Summary:
- Creatine kinase isoenzymes, lactate, lactate dehydrogenase, aspartate aminotransferase, hydroxybutyrate dehydrogenase, excitatory amino acids, glial fibrillary acidic protein, cytokines, neuron-specific enolase, oxypurines, and cyclic adenosine monophosphate were analyzed.
- The study revises the utility of these biochemical parameters in different body fluids.
- Emphasis is placed on their role in diagnosing and predicting the severity of HIE in newborns.
Impact:
- Provides a comprehensive overview of biochemical markers for HIE.
- Aids clinicians in selecting appropriate diagnostic and prognostic tools.
- Informs future research directions for identifying novel biomarkers of neonatal brain injury.
Introduction:
Hypoxemia, hypoxia and ischemia may induce deletereous effects on both metabolism and cellular structure, particularly at neuronal level. Early estimation of the potential severity of an acute cerebral hypoxic ischemic injury or other pathological conditions would be useful on making preventive or therapeutic decisions. On the basis of the physiopathological mechanisms involved in the brain damage related to hypoxic ischemic encephalopathy of the newborn, a number of metabolic parameters had been studied in the aim to provide an early and reliable marker of tissue injury for both diagnostic and prognostic purposes.
Objective:
To provide a current revision about the diagnostic and prognostic value of various biochemical parameters determined in different body fluids and studied in the last years, the attention focusing in the hypoxic ischemic encephalopathy of the newborn. Design. For methodological purposes the exposition is structured in the following sections: 1. creatine kinase isoenzymes; 2. lactate; 3. lactate dehydrogenase, aspartate aminotransferase and hidroxybutirate dehydrogenase; 4. excitatory amino acids; 5. glial fibrillary acidic protein; 6. cytokines; 7. neuron specific enolase; 8. oxypurines; 9. cyclic adenosine monophosphate; 10. Others.
Conclusions:
The current role of the above mentioned biochemical parameters as predictors of brain damage and the future perspectives on this topic are discussed.