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Martini S, Castellini L, Parladori R, Paoletti V, Aceti A, Corvaglia L. Free Radicals and Neonatal Brain Injury: From Underlying Pathophysiology to Antioxidant Treatment Perspectives. Antioxidants (Basel) 2021; 10:2012. [PMID: 34943115 PMCID: PMC8698308 DOI: 10.3390/antiox10122012] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/09/2021] [Accepted: 12/16/2021] [Indexed: 01/23/2023] Open
Abstract
Free radicals play a role of paramount importance in the development of neonatal brain injury. Depending on the pathophysiological mechanisms underlying free radical overproduction and upon specific neonatal characteristics, such as the GA-dependent maturation of antioxidant defenses and of cerebrovascular autoregulation, different profiles of injury have been identified. The growing evidence on the detrimental effects of free radicals on the brain tissue has led to discover not only potential biomarkers for oxidative damage, but also possible neuroprotective therapeutic approaches targeting oxidative stress. While a more extensive validation of free radical biomarkers is required before considering their use in routine neonatal practice, two important treatments endowed with antioxidant properties, such as therapeutic hypothermia and magnesium sulfate, have become part of the standard of care to reduce the risk of neonatal brain injury, and other promising therapeutic strategies are being tested in clinical trials. The implementation of currently available evidence is crucial to optimize neonatal neuroprotection and to develop individualized diagnostic and therapeutic approaches addressing oxidative brain injury, with the final aim of improving the neurological outcome of this population.
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Affiliation(s)
- Silvia Martini
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (A.A.); (L.C.)
- Neonatal Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Laura Castellini
- School of Medicine and Surgery, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy;
| | - Roberta Parladori
- Specialty School of Pediatrics, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy;
| | - Vittoria Paoletti
- Neonatal Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Arianna Aceti
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (A.A.); (L.C.)
- Neonatal Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Luigi Corvaglia
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (A.A.); (L.C.)
- Neonatal Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
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Sadeghzadeh M, Khoshnevisasl P, Fallah R, Marzban A, Mirrajei SM. The Urinary Uric Acid / Cr ratio as a marker of morbidity and mortality of preterm infants: a case-control study. BMC Pediatr 2021; 21:325. [PMID: 34301220 PMCID: PMC8305603 DOI: 10.1186/s12887-021-02798-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Perinatal asphyxia is one of the main causes of preterm infant mortality. Some studies have shown that The Urinary Uric Acid / Cr (UUA/Cr) ratio may be used as an additional marker for perinatal asphyxia.This study intend to investigate the relationship of this ratio with outcomes of preterm infants admitted to NICU. METHODS This case-control study was carried on 102 preterm newborn infants with gestational age of 30 weeks to 33 weeks and 6 days admitted in the neonatal intensive care unit.The case group, consisted of 51 premature neonates with a history of intubation, cardiopulmonary resuscitation, mechanical ventilation and Nasal continuous positive airway pressure (NCPAP) at birth, were compared with 51 matched neonates. The UUA/Cr ratio was measured in the first 24 h after birth. Complications during hospitalization, duration of hospitalization, and final outcome were evaluated. RESULTS The mean level of UUA/Cr ratio in case and control group were 5.4 ± 4.1 and 3.6 9 ± 2.9 respectively and this difference was statistically significant (p = 0.014). The UUA/Cr ratio were significantly higher in females, cesarean section delivery, Apgar score ≥ 8, neonates without any complication and neonates with less than 10 days of hospitalization. However, this ratio has no predictive value for the incidence of complications during hospitalization and long-term hospital stay for infants of the case group. CONCLUSIONS The Urinary Uric Acid / Cr ratio in the first 24 h after birth in preterm neonates who underwent intubation, NCPAP or cardiopulmonary resuscitation was higher than healthy neonates.
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Affiliation(s)
- Mansour Sadeghzadeh
- Zanjan Metabolic Disease Research Center, Department of Pediatrics, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Parisa Khoshnevisasl
- Zanjan Social Determinants of Health Research Center, Department of Pediatrics, Zanjan University of Medical Sciences, Zanjan, Iran. .,Department of Pediatrics, Ayatollah Moussavi Hospital, Zanjan, Iran.
| | - Ramezan Fallah
- Department of Epidemiology and Biostatistics, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Asghar Marzban
- Department of Pediatrics, School of Medicine, Ayatollah Moussavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Seyyedeh Maryam Mirrajei
- Department of Pediatrics, School of Medicine, Ayatollah Moussavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
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Martini S, Austin T, Aceti A, Faldella G, Corvaglia L. Free radicals and neonatal encephalopathy: mechanisms of injury, biomarkers, and antioxidant treatment perspectives. Pediatr Res 2020; 87:823-833. [PMID: 31655487 DOI: 10.1038/s41390-019-0639-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 09/19/2019] [Accepted: 09/22/2019] [Indexed: 12/11/2022]
Abstract
Neonatal encephalopathy (NE), most commonly a result of the disruption of cerebral oxygen delivery, is the leading cause of neurologic disability in term neonates. Given the key role of free radicals in brain injury development following hypoxia-ischemia-reperfusion, several oxidative biomarkers have been explored in preclinical and clinical models of NE. Among these, antioxidant enzyme activity, uric acid excretion, nitric oxide, malondialdehyde, and non-protein-bound iron have shown promising results as possible predictors of NE severity and outcome. Owing to high costs and technical complexity, however, their routine use in clinical practice is still limited. Several strategies aimed at reducing free radical production or upregulating physiological scavengers have been proposed for NE. Room-air resuscitation has proved to reduce oxidative stress following perinatal asphyxia and is now universally adopted. A number of medications endowed with antioxidant properties, such as melatonin, erythropoietin, allopurinol, or N-acetylcysteine, have also shown potential neuroprotective effects in perinatal asphyxia; nevertheless, further evidence is needed before these antioxidant approaches could be implemented as standard care.
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Affiliation(s)
- Silvia Martini
- Neonatology and Neonatal Intensive Care Unit, St. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
| | - Topun Austin
- Neonatal Intensive Care Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Arianna Aceti
- Neonatology and Neonatal Intensive Care Unit, St. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giacomo Faldella
- Neonatology and Neonatal Intensive Care Unit, St. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Luigi Corvaglia
- Neonatology and Neonatal Intensive Care Unit, St. Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Bellos I, Fitrou G, Pergialiotis V, Perrea DN, Papantoniou N, Daskalakis G. Random urine uric acid to creatinine and prediction of perinatal asphyxia: a meta-analysis. J Matern Fetal Neonatal Med 2018; 32:3864-3870. [PMID: 29712490 DOI: 10.1080/14767058.2018.1471677] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objective: The purpose of the present review is to evaluate whether urine uric acid to creatinine ratio is increased in perinatal asphyxia and hypoxic-ischemic encephalopathy (HIE), as well as to assess its predictive accuracy in the disease. Methods: We used the Medline (1966-2017), Scopus (2004-2017), Clinicaltrials.gov (2008-2017), Embase (1980-2017), Cochrane Central Register of Controlled Trials CENTRAL (1999-2017), and Google Scholar (2004-2017) databases in our primary search along with the reference lists of electronically retrieved full-text papers. The hierarchical summary receiver operating characteristic (HSROC) model was used for the meta-analysis of diagnostic accuracy. Results: Fourteen studies were finally included in the present review, that investigated 1226 neonates. Urinary uric acid to creatinine ratio was significantly higher in neonates with perinatal asphyxia than in healthy controls (mean differences (MD): 1.43 95%CI [1.17, 1.69]). Specifically, the mean difference for Sarnat stage 1 was 0.70 (95%CI [0.28, 1.13]), for stage 2 1.41 (95%CI [0.99, 1.84]), and for stage 3 2.71 (95%CI [2.08, 3.35]). The estimated sensitivity for the summary point was 0.90 (95%CI (0.82-0.95)), the specificity was 0.88 (95%CI (0.73-0.95)) and the diagnostic odds ratio was calculated at 63.62 (95%CI (17.08-236.96)). Conclusions: Urinary uric acid to creatinine ratio is a rapid and an easily detected biomarker that may help physicians identify neonates at risk of developing perinatal asphyxia and HIE. However, large-scale prospective studies are still needed to determine its value in predicting mortality, as well as short- and long-term adverse neurological outcomes.
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Affiliation(s)
- Ioannis Bellos
- a Laboratory of Experimental Surgery and Surgical Research , National and Kapodistrian University of Athens , Athens , Greece
| | - Georgia Fitrou
- a Laboratory of Experimental Surgery and Surgical Research , National and Kapodistrian University of Athens , Athens , Greece
| | - Vasilios Pergialiotis
- a Laboratory of Experimental Surgery and Surgical Research , National and Kapodistrian University of Athens , Athens , Greece
| | - Despina N Perrea
- a Laboratory of Experimental Surgery and Surgical Research , National and Kapodistrian University of Athens , Athens , Greece
| | - Nikolaos Papantoniou
- b 2nd Department of Obstetrics and Gynecology , Attikon University Hospital, National and Kapodistrian University of Athens , Athens , Greece
| | - Georgios Daskalakis
- c 1st Department of Obstetrics and Gynecology , Alexandra University Hospital, National and Kapodistrian University of Athens , Athens , Greece
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Alkholy UM, Abdalmonem N, Zaki A, Ali YF, Mohamed SA, Abdelsalam NI, Hashim MIA, Sekkien MA, Elsherbiny YM. Early predictors of brain damage in full-term newborns with hypoxic ischemic encephalopathy. Neuropsychiatr Dis Treat 2017; 13:2133-2139. [PMID: 28860770 PMCID: PMC5558899 DOI: 10.2147/ndt.s144225] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE OF THE STUDY To evaluate the value of serum creatine phosphokinase-brain specific (CK-BB) and urinary lactate/creatinine (L/C) ratio as early indicators of brain damage in full-term newborns with hypoxic ischemic encephalopathy (HIE). PATIENTS AND METHODS A case-control study including 25 full-term new-born infants with perinatal asphyxia who were admitted to neonatal intensive care unit (NICU) with a proven diagnosis of HIE, compared to 20 healthy age- and sex-matched full-term newborns. All newborn infants were subjected to full history taking, clinical examination, routine investigations (cord blood gases and complete blood picture), and assessment of serum CK-BB (cord blood, 6 and 24 hours after birth) and urinary L/C ratio (collected within the first 6 hours, on the 2nd and 3rd day after birth). RESULTS The serum CK-BB and urinary L/C ratio in infants with HIE were significantly higher in samples collected throughout the monitoring period when compared with the control group (all P<0.001). The cord CK-BB and urinary L/C ratio within the first 6 hours were significantly higher in infants with severe HIE than in infants with mild and moderate HIE (P<0.001). Cord CK-BB level at 12.5 U/L had 100% sensitivity and 84% specificity in the detection of severe HIE infants. Urinary L/C ratio of more than 10.5 collected within the first 6 hours after birth had 100% sensitivity and 78% specificity for the detection of severe HIE infants. CONCLUSION The serum CK-BB and urinary L/C ratio in HIE infants were significantly increased early in the course of the disease, which can be used as useful indicators for predicting the development of HIE.
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Affiliation(s)
| | | | - Ahmed Zaki
- Pediatric Department, Mansoura University, Egypt
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Patel KP, Makadia MG, Patel VI, Nilayangode HN, Nimbalkar SM. Urinary Uric Acid/Creatinine Ratio - A Marker For Perinatal Asphyxia. J Clin Diagn Res 2017; 11:SC08-SC10. [PMID: 28274014 DOI: 10.7860/jcdr/2017/22697.9267] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 09/09/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Perinatal hypoxia is one of the leading causes of perinatal mortality in developing countries. Both apgar score and arterial blood pH predict the neonatal mortality in asphyxia. Apgar score alone does not predict neurologic outcome and as it is influenced by various factors. This study was conducted to evaluate the utility and sensitivity of urinary uric acid to creatinine ratio (UA/Cr ratio) in asphyxia diagnosis, compared to invasive Arterial Blood Gas (ABG) analysis. AIM To assess the urinary uric acid/creatinine ratio as an additional marker for perinatal asphyxia compared with ABG analysis in apgar score monitoring. MATERIALS AND METHODS The present case control study was conducted at a teaching hospital in Central Gujarat. Data of 40 healthy newborns and 40 asphyxiated newborns were collected. In absence of regional estimates, a sample of size 39 was required to attain a power of 80% at 5% alpha (type I error) considering a moderate effect size of 0.65. (UA/Cr) ratio was measured from the spot urine sample collected during 24-72 hours of birth. Statistical analysis was performed by Independent t-test, Pearson's correlation coefficient (r) and Receiver Operating Characteristic (ROC) plots. RESULTS The mean (UA/Cr ratio) (2.75±0.18 vs 1.78±0.23) is significantly higher in asphyxiated group than in the control group (p<0.0001). Urinary UA/Cr ratio had negative correlation with blood pH (r= -0.27, p=0.18), which was not significant (p>0.05). Urinary UA/Cr ratio with criterion of >2.3 had 100% sensitivity, 100% specificity with AUC of 1 (p<0.0001) had a better predictive value. CONCLUSIONS Apgar score is usually reduced in neonates with congenital anomalies and premature neonates. Hence, it is preferable that the clinical diagnosis of asphyxia by apgar scores be supported by other investigations so that early decision can be taken about the level of care the baby needs. pH, lactates and base deficits change with establishment of respiration following resuscitation. However, pH, lactate, base deficit estimations are invasive and need rapid estimations. Non-invasive urinary UA/Cr ratio may be an answer to these issues as it easy, economical and equally efficient.
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Nariman S, Mosayebi Z, Sagheb S, Rastad H, Hosseininodeh SS. Urinary Uric Acid/Creatinine Ratio as a Marker of Mortality and Unfavorable Outcome in NICU-Admitted Neonates. IRANIAN JOURNAL OF PEDIATRICS 2016; 26:e5739. [PMID: 27729961 PMCID: PMC5046843 DOI: 10.5812/ijp.5739] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 04/17/2016] [Accepted: 05/13/2016] [Indexed: 11/16/2022]
Abstract
Background The survival of neonates who have been admitted to the NICU, especially premature infants with few mortality and morbidity, is the most important attitude. Objectives We presumed whether urinary uric acid/creatinine (UUA/Cr) ratio can be a marker of mortality and adverse outcome in neonates which were admitted to the NICU. Patients and Methods All preterm infants admitted to our NICU after birth from March 2014 to April 2015 were enrolled in this prospective cohort study. UUA/Cr was measured during the first day of life. The severity of diseases (indicated by the need for high set-up of mechanical ventilation, complications of prematurity, and duration of stay in the NICU) and neonatal death were considered to be the final unfavorable outcomes. The relationship between the Log-transformation (Ln) urinary uric acid/creatinine ratio and the Apgar score at the first and 5th minute after birth and the duration of stay were analyzed by using linear regression. Statistical analysis was done by using STATA version 11 (STATA Corp, TX, USA). A P < 0.05 was considered to be statistically significant. Results A total of 362 preterm infants with a mean gestational age of 32.7 (± 3.9) weeks were admitted to the NICU, out of whom 64 (17.6%) had severe disease and 43 (11.8%) died. The mean UUA/Cr ratio was significantly higher in the admitted neonates (3.30 ± 1.95 vs. 1.36 ± 0.42. P = 0.0001). There was a negative correlation between the UUA/Cr ratio and the 1-minute Apgar score (r = -0.17, P = 0.006) and the 5-minute Apgar score (r = -0.19, P = 0.003). The 1-minute Apgar scores were negatively correlated with the outcome (OR = 0.68; P < 0.001) and the duration of stay (β = -.28; P < 0.001). There was no significant correlation between 5-minute Apgar scores and the outcome. There was a significant positive correlation between the UUA/Cr ratio and an unfavorable outcome (OR = 1.24; CI %95: 1.06 to 1.43, P = 0.006) and increasing duration of stay (β = 0.17; P = 0.009). Conclusions The urinary uric acid/creatinine ratio can be used as a simple, noninvasive parameter of the severity of disease and mortality in NICU-admitted neonates.
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Affiliation(s)
- Shahin Nariman
- Department of Pediatrics, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Ziba Mosayebi
- Department of Pediatrics, Tehran University of Medical Sciences, Tehran, IR Iran
- Children’s Medical Center, Pediatric Center of Excellence, Tehran, IR Iran
| | - Setareh Sagheb
- Department of Pediatrics, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Setareh Sagheb, Department of Pediatrics, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-9122387976, E-mail:
| | - Hadith Rastad
- Research Development Center, Arash Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
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Bhongir AV, Yakama AVV, Saha S, Radia SB, Pabbati J. The Urinary Uric Acid/Creatinine Ratio is An Adjuvant Marker for Perinatal Asphyxia. EUROPEAN JOURNAL PHARMACEUTICAL AND MEDICAL RESEARCH 2015; 2:520-528. [PMID: 26998526 PMCID: PMC4793967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To assess the urinary uric acid/creatinine ratio (UA/Cr) in relation to Apgar score and cord blood gas analysis in identification of perinatal asphyxia and to define the cutoff values. DESIGN case control study. SETTING The newborns admitted in the department of pediatrics and NICU of Mediciti Institute of Medical Science, Ghanpur, Medchal mandal, Telangana from May-July 2011 were enrolled. PARTICIPANTS/PATIENTS The study was conducted on 31 (18 males, 13 females) controls and 18 (12males, 6 females) asphyxiated neonates. OUTCOME MEASURES 5ml of arterial cord blood of newborn collected at the time of birth and spot urine samples were collected within 24-72 hours of life. Cord blood gas analysis were done immediately and Urinary uric acid was measured by modified Uricase method, urinary creatinine by modified kinetic Jaffe's reaction. RESULTS The mean urinary uric acid and creatinine ratio (2.58± 0.48 vs 1.89 ± 0.59) is significantly higher in Asphyxiated group than in the control group. The umbilical cord blood pH had significant positive correlation with 1st minute Apgar score (r= 0.41, p=0.003), 5th minute Apgar (r= 0.44, p=0.002), while urinary UA/Cr ratio had significant negative correlation with cord blood pH (r= -0.63, p=0.002). Urinary UA/Cr ratio with criterion of >2.43 had 80% sensitivity, 87.5% specificity with AUC of 0.84 (p=0.003) had a better predictive value. CONCLUSIONS Urinary UA/Cr ratio is easy, non-invasive, painless and economical adjuvant parameter with better predictive value for diagnosing perinatal asphyxia with simple diagnostic equipment.
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Affiliation(s)
- Aparna Varma Bhongir
- Department of Biochemistry, MediCiti Institute of Medical Sciences, SHARE INDIA-Ghanpur, Medchal Mandal, Ranga Reddy district, Telangana, India 501401
| | | | - Subhajit Saha
- Department of Biochemistry, MediCiti Institute of Medical Sciences, SHARE INDIA-Ghanpur, Medchal Mandal, Ranga Reddy district, Telangana, India 501401
| | - Sejal B Radia
- Department of Biochemistry, MediCiti Institute of Medical Sciences, SHARE INDIA-Ghanpur, Medchal Mandal, Ranga Reddy district, Telangana, India 501401
| | - Jayalakshmi Pabbati
- Department of Pediatrics- MediCiti Institute of Medical Sciences, SHARE INDIA-Ghanpur, Medchal Mandal, Ranga Reddy district, Telangana, India 501401
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Lou BS, Wu PS, Liu Y, Wang JS. Effects of Acute Systematic Hypoxia on Human Urinary Metabolites Using LC-MS-Based Metabolomics. High Alt Med Biol 2014; 15:192-202. [DOI: 10.1089/ham.2013.1130] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Bih-Show Lou
- Chemistry Division, Center for General Education, Chang Gung University, Tao-Yuan, Taiwan, Republic of China
| | - Pei-Shan Wu
- Chemistry Division, Center for General Education, Chang Gung University, Tao-Yuan, Taiwan, Republic of China
| | - Yitong Liu
- Chemistry Division, Center for General Education, Chang Gung University, Tao-Yuan, Taiwan, Republic of China
| | - Jong-Shyan Wang
- Graduate Institute of Rehabilitation Science and Center for Healthy Aging Research, Chang Gung University, Tao-Yuan, Taiwan, Republic of China
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Abstract
Metabolomics is a new approach based on the systematic study of the full complement of metabolites in a biological sample. This technology consists of two sequential steps: (1) an experimental technique, based on nuclear magnetic resonance (NMR) spectroscopy or mass spectrometry, designed to profile low-molecular-weight compounds, and (2) multivariate data analysis. The metabolomic analysis of biofluids or tissues has been successfully used in the fields of physiology, diagnostics, functional genomics, pharmacology, toxicology, and nutrition. Recent studies have evaluated how physiological variables or pathological conditions can affect metabolomic profiles of different biofluids in pediatric populations. The overall metabolic status of the neonate is little known. If more information on perinatal/neonatal maturational processes and their metabolic background were available, the management of sick or preterm newborns might be improved. Currently, the use of metabolomics in neonatology is still in the pioneering phase. Meaningful diagnostic information and simple, noninvasive collection techniques make urine a particularly suitable biofluid for metabolomic approach in neonatal medicine, although blood has also been investigated. Different fields of neonatology such as postnatal maturation, asphyxia/hypoxia, inborn errors of metabolism, nutrition, nephrouropathies, nephrotoxicity, cardiovascular diseases, and other conditions have been investigated using a metabolomic approach. Together with genomics and proteomics, metabolomics appears to be a promising tool in neonatology for the monitoring of postnatal metabolic maturation, the identification of biomarkers as early predictors of outcome, the diagnosis and monitoring of various diseases, and the "tailored" management of neonatal disorders.
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Affiliation(s)
- Vassilios Fanos
- Neonatal Intensive Care Unit, Puericulture Institute and Neonatal Section, Department of Surgery, University of Cagliari, Italy
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Assessment of uric acid and lipid peroxidation in serum and urine after hypoxia–ischemia neonatal in rats. Neurol Sci 2010; 32:59-65. [DOI: 10.1007/s10072-010-0393-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Accepted: 07/23/2010] [Indexed: 01/29/2023]
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