USE OF BIOMARKERS IN DETECTING BRAIN INJURY FOLLOWING HIE

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。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1000名足月婴儿中的大约3名和近60%的极低出生体重(早产儿)新生儿中。在表现出HIE的窒息婴儿中，有20%-50%在新生儿期死亡。在幸存者中，高达25%的人有脑瘫形式的永久性神经心理障碍，有或没有相关的智力低下、学习障碍或癫痫。全身性窒息，其最终后果是HIE，有许多不同的病因。全身性窒息可能发生在分娩前(胎盘早剥、中毒、母体胶原血管疾病)、分娩期间(延长分娩、难产、异常)或分娩后(败血症、传染病、呼吸窘迫)。目前，还没有可靠的实验室测试来评估神经元损伤的程度。这项针对患有HIE的新生儿的研究旨在收集初步数据，以表征选定的血液和尿液生物标记物浓度与这些新生儿的体检和神经影像表现之间的关系。识别新生儿脑损伤的生物标志物将有几个重要的未来临床应用：1)根据HIE的严重程度对患者进行分层；2)更好地监测脑损伤引起的病理和康复的进展；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