Boston Children's Hospital, and Harvard Medical School, Boston, MA, USA.
Boston Children's Hospital, and Harvard Medical School, Boston, MA, USA.
Eur J Paediatr Neurol. 2018 May;22(3):440-450. doi: 10.1016/j.ejpn.2018.01.018. Epub 2018 Jan 31.
To assess to what extent the blood concentrations of proteins with neurotrophic and angiogenic properties measured during the first postnatal month convey information about the risk of sonographically-identified brain damage among very preterm newborns.
Study participants were 1219 children who had a cranial ultrasound scan during their stay in the intensive care nursery and blood specimens collected on 2 separate days at least a week apart during the first postnatal month. Concentrations of selected proteins in blood spots were measured with electrochemiluminescence or with a multiplex immunobead assay and the risks of cranial ultrasound images associated with top-quartile concentrations were assessed.
High concentrations of multiple inflammation-related proteins during the first 2 postnatal weeks were associated with increased risk of ventriculomegaly, while high concentrations of just 3 inflammation-related proteins were associated with increased risk of an echolucent/hypoechoic lesion (IL-6, IL-8, ICAM-1), especially on day 7. Concomitant high concentrations of IL6R and bFGF appeared to modulate the increased risks of ventriculomegaly and an echolucent lesion associated with inflammation. More commonly high concentrations of putative protectors/repair-enhancers did not appear to diminish these increased risks.
Our findings provide support for the hypothesis that endogenous proteins are capable of either protecting the brain against damage and/or enhancing repair of damage.
评估在出生后第一个月内测量的具有神经营养和血管生成特性的蛋白质的血液浓度在多大程度上可以提供有关极低出生体重儿超声识别脑损伤风险的信息。
研究参与者为 1219 名儿童，他们在重症监护病房期间接受了头颅超声扫描，并在出生后第一个月内至少相隔一周的 2 个不同日期采集了血液样本。用电化学发光法或多重免疫珠测定法测定血斑中选定蛋白质的浓度，并评估与最高四分位数浓度相关的颅超声图像的风险。
出生后前 2 周内多种炎症相关蛋白浓度升高与脑室内扩大的风险增加相关，而仅 3 种炎症相关蛋白浓度升高与回声透明/低回声病变（IL-6、IL-8、ICAM-1）的风险增加相关，尤其是在第 7 天。同时存在高浓度的 IL6R 和 bFGF 似乎可以调节与炎症相关的脑室内扩大和回声透明病变的风险增加。通常情况下，高浓度的潜在保护剂/修复增强剂似乎并没有降低这些风险增加。
我们的研究结果支持这样一种假设，即内源性蛋白质能够保护大脑免受损伤，或增强对损伤的修复。
