Division of Neonatology, Hospital Universitario Puerta del Mar, Cadiz, Spain.
Division of Physiology, School of Medicine, Instituto de Investigación Biomédica e Innovación en Ciencias Biomédicas de la Provincia de Cádiz (INiBICA), Universidad de Cadiz, Plaza Fragela sn, 4 piso 410, Cadiz, Spain.
Mol Neurobiol. 2018 Jun;55(6):4896-4910. doi: 10.1007/s12035-017-0693-1. Epub 2017 Jul 28.
Germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) remains a serious complication in the preterm newborn. The significant increase of survival rates in extremelye preterm newborns has also contributed to increase the absolute number of patients developing GMH-IVH. However, there are relatively few available animal models to understand the underlying mechanisms and peripheral markers or prognostic tools. In order to further characterize central complications and evolution of GMH-IVH, we injected collagenase intraventricularly to P7 CD1 mice and assessed them in the short (P14) and the long term (P70). Early complications at P14 included ventricle enlargement, increased bleeding, and inflammation. These alterations were maintained at P70, when increased tau phosphorylation and decreased neurogenesis were also observed, resulting in impaired learning and memory in these early adult mice. We additionally analyzed peripheral blood biomarkers in both our mouse model and preterm newborns with GMH-IVH. While MMP9 levels were not significantly altered in mice or newborns, reduced gelsolin levels and increased ubiquitin carboxy-terminal hydrolase L1 and tau levels were detected in GMH-IVH patients at birth. A similar profile was observed in our mouse model after hemorrhage. Interestingly, early changes in gelsolin and carboxy-terminal hydrolase L1 levels significantly correlated with the hemorrhage grade in newborns. Altogether, our data support the utility of this animal model to reproduce the central complications and peripheral changes observed in the clinic, and support the consideration of gelsolin, carboxy-terminal hydrolase L1, and tau as feasible biomarkers to predict the development of GMH-IVH.
脑室内出血(GMH-IVH)仍然是早产儿的严重并发症。极早产儿存活率的显著提高也导致 GMH-IVH 患者的绝对数量增加。然而,用于理解潜在机制以及外周标志物或预后工具的动物模型相对较少。为了进一步阐明 GMH-IVH 的中枢并发症和演变,我们向 P7 日龄 CD1 小鼠脑室内注射胶原酶,并在短期(P14 日龄)和长期(P70 日龄)对其进行评估。P14 日龄时的早期并发症包括脑室扩大、出血增加和炎症。这些改变在 P70 日龄时仍持续存在,同时观察到 tau 磷酸化增加和神经发生减少,导致这些早期成年小鼠学习和记忆受损。我们还分析了我们的小鼠模型和伴有 GMH-IVH 的早产儿的外周血生物标志物。虽然 MMP9 水平在小鼠或新生儿中没有明显改变,但在 GMH-IVH 患者出生时检测到降低的凝胶蛋白水平以及增加的泛素羧基末端水解酶 L1 和 tau 水平。在出血后,我们的小鼠模型也观察到了类似的情况。有趣的是,凝胶蛋白和羧基末端水解酶 L1 水平的早期变化与新生儿的出血程度显著相关。总之,我们的数据支持该动物模型可用于复制临床上观察到的中枢并发症和外周变化,并支持将凝胶蛋白、羧基末端水解酶 L1 和 tau 作为预测 GMH-IVH 发展的可行生物标志物。