Vascular endothelial growth factor in neonates with perinatal asphyxia
Vascular endothelial growth factor in neonates with perinatal asphyxia
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DOI：
10.1016/j.braindev.2008.09.004
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发表时间：
2009-09-01
影响因子：
1.7
通讯作者：
Atiea, Wael
中科院分区：
文献类型：
--
作者：
Aly, Hany;Hassanein, Sahar;Atiea, Wael
背景：血管内皮生长因子（VEGF）是一种由组织缺氧激活的多肽生长因子。 VEGF 在人类新生儿围产期窒息中的作用尚未明确。对于患有中度至重度急性缺氧缺血性脑病 (HIE) 的婴儿，在开发新的治疗方法之前，清楚了解 HIE 伴随的生理和生化变化至关重要。目的：评估围产期窒息婴儿脐带血中的 VEGF，并确定 VEGF 浓度升高与脑病发生风险之间是否存在关联。学习设计。我们前瞻性地研究了 40 名足月婴儿；其中20名婴儿患有围产期窒息，20名年龄和性别相当的对照婴儿。我们在分娩后立即从所有受试者中获取了脐带血样本。在出生第一天进行神经学检查和 HIE 分级。结果：对照组 (n = 20) 和窒息组 (n = 20) 的出生体重、胎龄和性别没有差异。窒息组中有四名婴儿出现 HIE，其中一名患有严重脑病，出生后不久死亡，而其他三名婴儿则患有中度 HIE。与对照组相比，窒息婴儿的 VEGF 浓度升高（P < 0.001）。在窒息组中，与非 HIE 窒息婴儿相比，患有 HIE 的婴儿 VEGF 浓度显着升高 (P = 0.008)。在Logistic回归模型中，VEGF与脐带血pH、PO(2)以及1分钟Apgar评分呈负相关，而与胎龄和出生体重无关。结论：本研究表明，出生窒息后新生儿脐带血中 VEGF 升高，并且在后来发生脑病的婴儿中 VEGF 升高最为明显。需要进一步的研究来确定 VEGF 在脑损伤中的作用。此类研究将有助于确定 VEGF 或 VEGF 抑制剂是否对 HIE 婴儿具有治疗作用。 (C) 2008 Elsevier B.V. 保留所有权利。
Background: Vascular endothelial growth factor (VEGF) is a polypeptide growth factor that is activated by tissue hypoxia. The role of VEGF in perinatal asphyxia in human neonates is yet to be clarified. In infants who develop moderate to severe acute hypoxic ischemic encephalopathy (HIE) it is crucial to clearly understand physiologic and biochemical changes that accompany HIE before a novel treatment can be developed. Objectives: To assess VEGF in cord blood of infants suffering from perinatal asphyxia, and to determine whether an association exists between increased concentrations of VEGF and the risk for development of encephalopathy. Study design. We prospectively studied 40 full term infants; of them 20 infants suffered from perinatal asphyxia, and 20 control infants of comparable age and sex. We obtained cord blood samples from all subjects immediately after delivery. Neurological examination and grading of HIE were performed during the first day of life. Results: Birth weight, gestational age and gender did not differ between the control (n = 20) and asphyxia (n = 20) groups. Within the asphyxia group four infants developed HIE, one with severe encephalopathy who died shortly after birth, while the other three infants had moderate HIE. Concentrations of VEGF were increased in infants with asphyxia when compared to controls (P < 0.001). Within the asphyxia group, infants with HIE had significantly increased concentrations of VEGF when compared to non-HIE asphyxiated infants (P = 0.008). In the logistic regression model, VEGF inversely correlated with pH and PO(2) in cord blood, and Apgar scores at 1 min, while it did not associate with gestational age and birth weight. Conclusions: This study indicates that VEGF is increased in cord blood of neonates following birth asphyxia, and that VEGF is specifically most increased in infants who later developed encephalopathy. Further studies are required to determine the role of VEGF in brain insult. Such studies will help determine whether a therapeutic role for VEGF or VEGF inhibitors can exist for HIE infants. (C) 2008 Elsevier B.V. All rights reserved.