Seo Yu-Mi, Hwang-Bo Seok, Im Soo-Ah, Kim Myungshin, Youn Young-Ah
Department of Pediatrics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
Diagnostics (Basel). 2022 Apr 13;12(4):981. doi: 10.3390/diagnostics12040981.
This study aims to evaluate significant gene expression in severe hypoxic ischemic encephalopathy (HIE) in newborns, which can be used as a predictable measure for high-risk HIE infants. The study prospectively recruited 77 inborn near-term or term HIE newborns between January 2018 and December 2020. We measured six different genes within 6 h of life among the HIE infants and compared the gene levels between the mild- and severe-HIE groups. Among these, 64 HIE infants (83.1%) did not receive therapeutic hypothermia (TH) because they were categorized as mild HIE, and the 13 remaining (16.9%) infants were categorized as ≥ moderate-HIE group and received TH. More abnormal MRI findings, seizure, and use of anti-convulsant were more found in the ≥ moderate = HIE group along with longer mechanical ventilation days and hospitalization. Heat-shock protein 70 family 1 A (HSPA1A) and serpin family H member 1 (SERPINH1) genes, which encode heat-shock protein (HSP) 70 and 47, respectively, were significantly elevated in the ≥ moderate-HIE, seizure, and abnormal MRI groups. HSP 70 and 47 were significantly elevated in the severe-HIE group, possibly playing protective roles in inhibiting exacerbated neuroinflammation and maintaining a cellular homeostasis. At 18-24 months, ≥ moderate-HIE group manifested a significant language delay.
本研究旨在评估新生儿重度缺氧缺血性脑病（HIE）中的显著基因表达情况，其可作为高危HIE婴儿的一种预测指标。该研究前瞻性招募了2018年1月至2020年12月期间77例近足月或足月出生的HIE新生儿。我们在HIE婴儿出生后6小时内检测了6种不同的基因，并比较了轻度和重度HIE组之间的基因水平。其中，64例HIE婴儿（83.1%）因被归类为轻度HIE而未接受治疗性低温（TH），其余13例（16.9%）婴儿被归类为≥中度HIE组并接受了TH。≥中度HIE组出现更多异常MRI表现、惊厥，且抗惊厥药物使用更多，同时机械通气天数和住院时间更长。分别编码热休克蛋白（HSP）70和47的热休克蛋白70家族1A（HSPA1A）和丝氨酸蛋白酶抑制剂家族H成员1（SERPINH1）基因在≥中度HIE、惊厥和异常MRI组中显著升高。HSP 70和47在重度HIE组中显著升高，可能在抑制神经炎症加剧和维持细胞内稳态方面发挥保护作用。在18至24个月时，≥中度HIE组出现明显的语言发育迟缓。
