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Brain Damage in Preterm and Full-Term Neonates: Serum Biomarkers for the Early Diagnosis and Intervention
Serafina Perrone1, Federica Grassi2, Chiara Caporilli2
1Neonatology Unit, Pietro Barilla Children's Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.
Insights
Oxidative stress (OS) is a key factor in neonatal brain injury. Early detection via serum biomarkers is crucial for neuroprotection, but reliable markers are needed for timely intervention.
Area of Science:
- Neuroscience
- Biochemistry
- Neonatology
Background:
- Neonatal brain injury can result from pre-, peri-, and post-natal insults.
- Oxidative stress (OS) is increasingly recognized as a common pathway for these insults.
- Newborns are highly susceptible to OS due to underdeveloped antioxidant defenses.
Purpose of the Study:
- To review current evidence on serum biomarkers for early identification of neurological diseases in newborns.
- To highlight the need for sensitive and rapid assays for clinical application.
- To emphasize the importance of correlating biomarkers with brain injury type and severity for improved prognosis.
Main Methods:
- Educational review of existing literature on serum biomarkers for neonatal neurological diseases.
- Analysis of the role of oxidative stress in neonatal brain injury.
- Discussion of the clinical utility and limitations of current biomarkers like S-100B.
Main Results:
- Oxidative stress is a significant contributor to neonatal brain injury.
- Current biomarkers, such as S-100B, have limitations in clinical practice due to complexity and timing issues.
- There is a lack of reliable, early-acting serum markers for neonatal neurological conditions.
Conclusions:
- Early identification of high-risk newborns for neurological diseases requires effective serum biomarkers.
- Developing sensitive, rapid biomarker assays is essential for timely neuroprotective strategies.
- Further research should focus on the association between biomarkers and the specific type and severity of perinatal brain damage for optimal patient outcomes.
Abstract:
The Brain is vulnerable to numerous insults that can act in the pre-, peri-, and post-natal period. There is growing evidence that demonstrate how oxidative stress (OS) could represent the final common pathway of all these insults. Fetuses and newborns are particularly vulnerable to OS due to their inability to active the antioxidant defenses. Specific molecules involved in OS could be measured in biologic fluids as early biomarkers of neonatal brain injury with an essential role in neuroprotection. Although S-100B seems to be the most studied biomarker, its use in clinical practice is limited by the complexity of brain damage etiopathogenesis and the time of blood sampling in relation to the brain injury. Reliable early specific serum markers are currently lacking in clinical practice. It is essential to determine if there are specific biomarkers that can help caregivers to monitor the progression of the disease in order to active an early neuroprotective strategy. We aimed to describe, in an educational review, the actual evidence on serum biomarkers for the early identification of newborns at a high risk of neurological diseases. To move the biomarkers from the bench to the bedside, the assays must be not only be of a high sensitivity but suitable for the very rapid processing and return of the results for the clinical practice to act on. For the best prognosis, more studies should focus on the association of these biomarkers to the type and severity of perinatal brain damage.
