USE OF BIOMARKERS IN DETECTING BRAIN INJURY FOLLOWING HIE

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。新生儿缺氧缺血性脑病（HIE）是全身性窒息的脑表现。全身性窒息发生在约3/1000的足月婴儿和近60%的极低出生体重（早产）新生儿中。20-50%的窒息新生儿在新生儿期死亡。在幸存者中，高达25%的人有永久性的神经心理障碍，表现为脑瘫，伴有或不伴有相关的智力迟钝、学习障碍或癫痫。 全身性窒息的最终后果是HIE，有许多不同的病因。全身性窒息可能发生在分娩前（胎盘破裂、毒血症、母体胶原血管疾病）、分娩期间（产程延长、难产、异常表现）或分娩后（败血症、感染性疾病、呼吸窘迫）。目前，没有可靠的实验室测试来评估神经元损伤的程度。本研究在患有HIE的新生儿中进行，旨在收集表征这些新生儿的选定血液和尿液生物标志物浓度与体格检查和神经影像学结果之间相关性的初步数据。鉴定新生儿脑损伤的生物标志物将具有几个重要的未来临床应用：1）根据其HIE的严重程度对患者进行分层; 2）更好地监测脑损伤诱导的病理和恢复的进展; 3）监测治疗/干预的效果;以及4）更准确地预测HIE后的结果

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Hypoxic ischemic encephalopathy (HIE) is the brain manifestation of systemic asphyxia. Systemic asphyxia occurs in about 3 out of 1,000 full-term infants and in nearly 60% of very low birth weight (premature) newborns. Between 20-50% of asphyxiated babies who exhibit HIE die during the newborn period. Of the survivors, up to 25% have permanent neuropsychologic handicaps in the form of cerebral palsy, with or without associated mental retardation, learning disabilities, or epilepsy. Systemic asphyxia, with the end consequences being HIE, has many different etiologies. Systemic asphyxia may occur prior to delivery (placental abruptio, toxemia, maternal collagen vascular disease), during delivery (prolonged labor, difficult delivery, abnormal presentation) or after delivery (sepsis, infectious disease, respiratory distress). Currently, there is no reliable laboratory test to assess the degree of neuronal injury. This study in neonates suffering HIE is designed to collect preliminary data characterizing the association between the concentrations of selected blood and urine biomarkers and the physical exam and neuroimaging findings of these neonates. Identification of biomarkers of brain injury in neonates will have several important future clinical applications: 1) to stratify patients by the severity of their HIE; 2) to better monitor the progression of brain injury-induced pathology and recovery; 3) to monitor the effects of therapy/intervention; and 4) to predict outcome more accurately after HIE