The breadth and type of systemic inflammation and the risk of adverse neurological outcomes in extremely low gestation newborns.
The breadth and type of systemic inflammation and the risk of adverse neurological outcomes in extremely low gestation newborns.
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DOI：
10.1016/j.pediatrneurol.2014.10.005
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发表时间：
2015-01
影响因子：
3.8
通讯作者：
ELGAN Study Investigators
中科院分区：
文献类型：
--
作者：
Kuban KC;O'Shea TM;Allred EN;Fichorova RN;Heeren T;Paneth N;Hirtz D;Dammann O;Leviton A;ELGAN Study Investigators
我们假设，极早产儿脑损伤的风险随着全身炎症的广度和类型而增加，由升高的炎症相关蛋白的数量和呈现升高浓度的炎症相关蛋白的功能类别的数量来索引。在881名孕28周前出生的婴儿的血液中，我们测量了25种炎症相关蛋白的浓度，代表6种功能类别（细胞因子、趋化因子、生长因子、粘附分子、金属蛋白酶和肝脏产生的急性期反应物蛋白），和14，并评估了在一周内的两个不同的时间点上浓度升高的蛋白质的数量和类型与新生儿脑室扩大的诊断之间的关联，并且，在2岁时，小头畸形、早期认知功能受损、脑瘫和自闭症风险（使用幼儿自闭症改良检查表（M-CHAT）筛查进行评估），以及来自14个站点中12个站点的这些儿童的子集（n= 826）中，使用儿童行为检查表（CBCL）确定的注意力问题。在25蛋白反复/持续升高的儿童中，大脑结构和功能异常的风险总体上增加。大多数结果的风险不会增加，直到至少两个功能类别中的至少四种蛋白质升高。当我们集中分析10种先前发现与神经系统结局一致相关的蛋白质时，我们发现贝利婴儿发育量表-II，小头畸形和CBCL定义的注意力问题的低智力发育指数（MDI）的风险随着这些反复/持续升高的蛋白质数量的增加而增加。早期新生儿炎症范围的增加（以蛋白质升高的数量或蛋白质功能类别升高的数量为指标）与极早产儿脑结构和功能障碍风险的增加相关。
We hypothesized that the risk of brain damage in extremely preterm neonates increases with the breadth and type of systemic inflammation, indexed by the number of elevated inflammation-related proteins and the number of functional categories of inflammation-related proteins exhibiting an elevated concentration. In blood from 881 infants born before 28 weeks gestation, we measured the concentrations of 25 inflammation-related proteins, representing 6 functional categories (cytokines, chemokines, growth factors, adhesion molecules, metalloproteinases, and liver-produced acute phase reactant proteins) on postnatal days 1, 7, and 14 and evaluated associations between the number and type of proteins whose concentrations were elevated on two separate occasions a week apart and the diagnoses of ventriculomegaly as a neonate, and, at 2 years, microcephaly, impaired early cognitive functioning, cerebral palsy, and autism risk as assessed with the Modified Checklist for Autism in Toddlers (M-CHAT) screen, and, in a subset of these children from 12 of 14 sites (n= 826), an attention problem identified with the Child Behavior Checklist (CBCL). The risk of abnormal brain structure and function overall was increased among children who had recurrent/persistent elevations of the 25 protein. The risk for most outcomes did not rise until at least four proteins in at least two functional categories were elevated. When we focused our analysis on 10 proteins previously found to be associated consistently with neurological outcomes, we found the risk of low Mental Development Index (MDI) on the Bayley Scales of Infant Development-II, microcephaly, and a CBCL-defined attention problem increased with higher numbers of these recurrently/persistently elevated proteins. Increasing breadth of early neonatal inflammation, indexed by the number of protein elevations or the number of protein functional classes elevated, is associated with increasing risk of disorders of brain structure and function among infants born extremely premature.
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影响因子：
64.5
作者：
Cho Y;Sloutsky R;Naegle KM;Cavalli V
通讯作者：
Cavalli V
影响因子：
2.1
作者：
Dammann O;O'Shea TM
通讯作者：
O'Shea TM
影响因子：
2.1
作者：
Albertine KH
通讯作者：
Albertine KH
影响因子：
11
作者：
Ladd-Acosta, C.;Hansen, K. D.;Briem, E.;Fallin, M. D.;Kaufmann, W. E.;Feinberg, A. P.
通讯作者：
Feinberg, A. P.
影响因子：
2.5
作者：
Leviton, Alan;Kuban, Karl C. K.;Paneth, Nigel
通讯作者：
Paneth, Nigel