Toshihiko Nakamura1, Hideomi Asanuma2, Satoshi Kusuda3, Ken Imai3, Shigeharu Hosono4, Ryota Kato4, Satoshi Suzuki5, Kyoko Yokoi5, Minoru Kokubo6, Shingo Yamada7, Takashi Kamohara1. 1. Neonatology, Musashino Red Cross Hospital, Sapporo, Japan. 2. Department of Neonatal Medicine, Maternal and Perinatal Center, Tokyo Women's Medical University, Itabshi, Japan. 3. Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan. 4. Division of Neonatology, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Japan. 5. Department of Pediatrics, Nagoya City West Medical Center, Nagoya, Japan. 6. Department of Pediatrics, Aichi Prefectural Welfare Federation of Agricultural Cooperatives Kainan Hospital, Nagoya, Aichi, Japan. 7. Division of Development, Shino-Test Corporation Sagamihara, Kanagawa, Japan.
Abstract
BACKGROUND: We measured changes in the blood level of high-mobility group box-1 (HMGB-1) at 24 h intervals in neonates treated with brain/body hypothermia (body hypothermia therapy: BHT) for hypoxic-ischemic encephalopathy (HIE), to evaluate the usefulness of HMGB-1 level for determining outcomes. METHODS: We studied 15 neonates with HIE who underwent BHT (BHT (+) group) and six neonates with HIE who did not (BHT (-) group). We recorded HMGB-1 changes at 24 h intervals, creatinine phosphokinase, and the resistance index of the anterior cerebral artery. Magnetic resonance imaging (MRI) was used to determine short-term outcome. RESULT: Baseline HMGB-1 was significantly higher in the BHT (+) group than in the BHT (-) group. Thereafter, HMGB-1 in the BHT (+) group significantly decreased at 24 h intervals, reaching the reference range by 2 days of age. In the BHT (+) group, when patients were classified into clinically significant neurological disorder due to HIE (+) and (-) according to MRI, the neurological disorder (+) group had higher mean HMGB-1. CONCLUSIONS: In HIE, HMGB-1 differs according to the presence of BHT, suggesting that HMGB-1 measurement soon after birth might be useful for determining BHT necessity and short-term outcome.
BACKGROUND: We measured changes in the blood level of high-mobility group box-1 (HMGB-1) at 24 h intervals in neonates treated with brain/body hypothermia (body hypothermia therapy: BHT) for hypoxic-ischemicencephalopathy (HIE), to evaluate the usefulness of HMGB-1 level for determining outcomes. METHODS: We studied 15 neonates with HIE who underwent BHT (BHT (+) group) and six neonates with HIE who did not (BHT (-) group). We recorded HMGB-1 changes at 24 h intervals, creatinine phosphokinase, and the resistance index of the anterior cerebral artery. Magnetic resonance imaging (MRI) was used to determine short-term outcome. RESULT: Baseline HMGB-1 was significantly higher in the BHT (+) group than in the BHT (-) group. Thereafter, HMGB-1 in the BHT (+) group significantly decreased at 24 h intervals, reaching the reference range by 2 days of age. In the BHT (+) group, when patients were classified into clinically significant neurological disorder due to HIE (+) and (-) according to MRI, the neurological disorder (+) group had higher mean HMGB-1. CONCLUSIONS: In HIE, HMGB-1 differs according to the presence of BHT, suggesting that HMGB-1 measurement soon after birth might be useful for determining BHT necessity and short-term outcome.
Keywords:
brain/body hypothermia; high-mobility group box-1; hypoxic-ischemic encephalopathy; magnetic resonance imaging; recombinant human thrombomodulin