OBJECTIVES The aim of the study was to evaluate neuronal injury and immuno-inflammatory biomarkers in umbilical cord blood (UCB) at birth, in cases with perinatal asphyxia with or without hypoxic-ischemic encephalopathy (HIE), compared with healthy controls and to assess their ability to predict HIE. STUDY DESIGN In this case-control study, term infants with perinatal asphyxia were recruited at birth. UCB was stored at delivery for batch analysis. HIE was diagnosed by clinical Sarnat staging at 24 h. Glial fibrillary acidic protein (GFAP), the neuronal biomarkers tau and neurofilament light protein (NFL), and a panel of cytokines were analyzed in a total of 150 term neonates: 50 with HIE, 50 with asphyxia without HIE (PA), and 50 controls. GFAP, tau, and NFL concentrations were measured using ultrasensitive single-molecule array (Simoa) assays, and a cytokine screening panel was applied to analyze the immuno-inflammatory and infectious markers. RESULTS GFAP, tau, NFL, and several cytokines were significantly higher in newborns with moderate and severe HIE compared to a control group and provided moderate prediction of HIE II/III (AUC: 0.681-0.827). Furthermore, the levels of GFAP, tau, interleukin-6 (IL-6), and interleukin-8 (IL-8) were higher in HIE II/III cases compared with cases with PA/HIE I. IL-6 was also higher in HIE II/III compared with HIE I cases. CONCLUSIONS Biomarkers of brain injury and inflammation were increased in umbilical blood in cases with asphyxia. Several biomarkers were higher in HIE II/III versus those with no HIE or HIE I, suggesting that they could assist in the prediction of HIE II/III.

中文翻译：

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新生儿缺氧缺血性脑病脐带血中的神经特异性和免疫炎症生物标志物。

目的 该研究的目的是与健康对照者相比，在伴有或不伴有缺氧缺血性脑病 (HIE) 的围产期窒息病例中，评估出生时脐带血 (UCB) 中的神经元损伤和免疫炎症生物标志物，并评估其神经元损伤和免疫炎症生物标志物。预测 HIE 的能力。研究设计 在这项病例对照研究中，招募了出生时患有围产期窒息的足月儿。UCB 在交货时储存用于批量分析。24 小时通过临床 Sarnat 分期诊断为 HIE。对总共 150 名足月新生儿进行了神经胶质原纤维酸性蛋白 (GFAP)、神经元生物标志物 tau 和神经丝轻蛋白 (NFL) 以及一组细胞因子的分析：50 名患有 HIE，50 名患有窒息但不伴有 HIE (PA)，50 名新生儿患有 HIE (PA)。控制。使用超灵敏单分子阵列 (Simoa) 测定法测量 GFAP、tau 和 NFL 浓度，并应用细胞因子筛选组来分析免疫炎症和感染标记物。结果 与对照组相比，中度和重度 HIE 新生儿的 GFAP、tau、NFL 和多种细胞因子显着升高，并提供了 HIE II/III 的中等预测（AUC：0.681-0.827）。此外，与 PA/HIE I 病例相比，HIE II/III 病例中 GFAP、tau、白细胞介素 6 (IL-6) 和白介素 8 (IL-8) 水平较高。IL-6 也较高HIE II/III 病例与 HIE I 病例相比。结论 窒息病例脐血中脑损伤和炎症的生物标志物增加。HIE II/III 中的一些生物标志物比那些没有 HIE 或 HIE I 的人更高，这表明它们可以帮助预测 HIE II/III。