Boskabadi Hassan, Omidian Masoud, Tavallai Shima, Mohammadi Shabnam, Parizadeh Mostafa, Ghayour Mobarhan Majid, Ferns Gordon Aa
Department of Pediatrics, Neonatal Research Center, Ghaem Hospital, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran.
Biochemistry and Nutrition Research Center, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran ; Cardiovascular Research Center, Mashhad University of Medical Sciences (MUMS), Mashhad, IR Iran.
Iran J Pediatr. 2015 Apr;25(2):e381. doi: 10.5812/ijp.381. Epub 2015 Apr 18.
Perinatal asphyxia is an important cause of mortality and permanent neurological and developmental deficit. Early and accurate diagnosis would help to establish the likely prognosis and may also help in determining the most appropriate treatment. Studies in experimental animal models suggest that a protein called Hsp70 may be a good and potentially useful marker of cellular stress that may be clinically useful in determining the presence of neonatal asphyxia.
Regarding the importance of early and accurate diagnosis of asphyxia, we conducted this study, which is the first investigation of the comparison of the serum Hsp70 antigen level between asphyxiated and healthy infants.
In this observational study, the serum concentrations of Hsp70 antigen were compared between neonates suffering from perinatal asphyxia (n = 50) and normal neonates (n = 51). The inclusion criteria for the cases were neonates who had reached term and had at least two clinical criteria of asphyxia. Exclusion criteria were babies with gestational age < 37 weeks, infants with congenital abnormalities or positive blood culture. Exclusion criteria in this group were the requirement to hospital stay during first week of the life or babies whose mothers had difficulties during pregnancy or delivery. Term neonates without major anomalies who had asphyxia during delivery were enrolled in the first six hours after delivery, and control group consisted of healthy term neonates without problems and normal delivery process in the first week of life. The cord blood was taken during labor to measure Hsp70 antigen level by using an in-house ELISA (The enzyme-linked immunosorbent assay).
The median values of serum anti Hsp70 titers were significantly higher in asphyxiated neonates compared with non-asphyxiated neonates (0.36 [0.04 - 1.14] vs 0.24 [0.01 - 0.63]). At cutoff point = 0.3125 ng/mL, sensitivity was 58% and specificity 76% based on ROC curve.
A significant difference between the serum concentrations of Hsp70 of the control and patient group was observed in this study. It is inferred serum concentrations of Hsp70 antigen may be a useful marker for the early diagnosis of that prenatal hypoxia.
围产期窒息是导致死亡以及永久性神经和发育缺陷的重要原因。早期准确诊断有助于确定可能的预后，也有助于确定最合适的治疗方法。对实验动物模型的研究表明，一种名为热休克蛋白70（Hsp70）的蛋白质可能是细胞应激的良好且潜在有用的标志物，在临床上可能有助于确定新生儿窒息的存在。
鉴于窒息早期准确诊断的重要性，我们开展了本研究，这是首次对窒息婴儿与健康婴儿血清Hsp70抗原水平进行比较的调查。
在这项观察性研究中，比较了围产期窒息新生儿（n = 50）和正常新生儿（n = 51）血清中Hsp70抗原的浓度。病例的纳入标准为足月且至少有两项窒息临床标准的新生儿。排除标准为孕周<37周的婴儿、患有先天性异常或血培养阳性的婴儿。该组的排除标准为出生后第一周需住院或母亲在孕期或分娩时有困难的婴儿。分娩时窒息且无重大异常的足月新生儿在出生后前6小时入组，对照组由出生后第一周无问题且分娩过程正常的健康足月新生儿组成。分娩时采集脐带血，使用内部酶联免疫吸附测定法（ELISA）测量Hsp70抗原水平。
窒息新生儿血清抗Hsp70滴度的中位数显著高于未窒息新生儿（0.36 [0.04 - 1.14] 对 0.24 [0.01 - 0.63]）。根据ROC曲线，在临界值 = 0.3125 ng/mL时，敏感性为58%，特异性为76%。
本研究观察到对照组和患者组血清Hsp70浓度存在显著差异。推断血清Hsp70抗原浓度可能是产前缺氧早期诊断的有用标志物。
