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Metallinou D, Karampas G, Pavlou ML, Louma MI, Mantzou A, Sarantaki A, Nanou C, Gourounti K, Tzeli M, Pantelaki N, Tzamakos E, Boutsikou T, Lykeridou A, Iacovidou N. Serum Neuron-Specific Enolase as a Biomarker of Neonatal Brain Injury-New Perspectives for the Identification of Preterm Neonates at High Risk for Severe Intraventricular Hemorrhage. Biomolecules 2024; 14:434. [PMID: 38672451 PMCID: PMC11048112 DOI: 10.3390/biom14040434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 03/30/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
Neonatal brain injury (NBI) is a critical condition for preterm neonates with potential long-term adverse neurodevelopmental outcomes. This prospective longitudinal case-control study aimed at investigating the levels and prognostic value of serum neuron-specific enolase (NSE) during the first 3 days of life in preterm neonates (<34 weeks) that later developed brain injury in the form of either periventricular leukomalacia (PVL) or intraventricular hemorrhage (IVH) during their hospitalization. Participants were recruited from one neonatal intensive care unit, and on the basis of birth weight and gestational age, we matched each case (n = 29) with a neonate who had a normal head ultrasound scan (n = 29). We report that serum NSE levels during the first three days of life do not differ significantly between control and preterm neonates with NBI. Nevertheless, subgroup analysis revealed that neonates with IVH had significantly higher concentrations of serum NSE in comparison to controls and neonates with PVL on the third day of life (p = 0.014 and p = 0.033, respectively). The same pattern on the levels of NSE on the third day of life was also observed between (a) neonates with IVH and all other neonates (PVL and control; p = 0.003), (b) neonates with II-IV degree IVH and all other neonates (p = 0.003), and (c) between control and the five (n = 5) neonates that died from the case group (p = 0.023). We conclude that NSE could be an effective and useful biomarker on the third day of life for the identification of preterm neonates at high risk of developing severe forms of IVH.
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Affiliation(s)
- Dimitra Metallinou
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.-L.P.); (A.S.); (C.N.); (K.G.); (M.T.); (N.P.); (E.T.); (A.L.)
- School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Grigorios Karampas
- Second Department of Obstetrics and Gynaecology, Aretaieio Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Maria-Loukia Pavlou
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.-L.P.); (A.S.); (C.N.); (K.G.); (M.T.); (N.P.); (E.T.); (A.L.)
| | - Maria-Ioanna Louma
- Department of Biochemistry & Biotechnology, University of Thessaly, 41500 Larissa, Greece;
| | - Aimilia Mantzou
- Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, Medical School, Aghia Sophia Children’s Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Antigoni Sarantaki
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.-L.P.); (A.S.); (C.N.); (K.G.); (M.T.); (N.P.); (E.T.); (A.L.)
| | - Christina Nanou
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.-L.P.); (A.S.); (C.N.); (K.G.); (M.T.); (N.P.); (E.T.); (A.L.)
| | - Kleanthi Gourounti
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.-L.P.); (A.S.); (C.N.); (K.G.); (M.T.); (N.P.); (E.T.); (A.L.)
| | - Maria Tzeli
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.-L.P.); (A.S.); (C.N.); (K.G.); (M.T.); (N.P.); (E.T.); (A.L.)
| | - Nikoletta Pantelaki
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.-L.P.); (A.S.); (C.N.); (K.G.); (M.T.); (N.P.); (E.T.); (A.L.)
| | - Evangelos Tzamakos
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.-L.P.); (A.S.); (C.N.); (K.G.); (M.T.); (N.P.); (E.T.); (A.L.)
| | - Theodora Boutsikou
- Department of Neonatology, School of Medicine, Aretaieio Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (T.B.); (N.I.)
| | - Aikaterini Lykeridou
- Department of Midwifery, University of West Attica, 12243 Athens, Greece; (M.-L.P.); (A.S.); (C.N.); (K.G.); (M.T.); (N.P.); (E.T.); (A.L.)
| | - Nicoletta Iacovidou
- Department of Neonatology, School of Medicine, Aretaieio Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (T.B.); (N.I.)
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Dugalic S, Todorovic J, Sengul D, Sengul I, Veiga ECDA, Plesinac J, Petronijevic M, Macura M, Kepeci SP, Milinčić M, Pavlovic A, Gojnic M. Highlighting early detection of thyroid pathology and gestational diabetes effects on oxidative stress that provokes preterm delivery in thyroidology: Does that ring a bell? Clinics (Sao Paulo) 2023; 78:100279. [PMID: 37783171 PMCID: PMC10562150 DOI: 10.1016/j.clinsp.2023.100279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 08/05/2023] [Accepted: 08/08/2023] [Indexed: 10/04/2023] Open
Abstract
OBJECTIVES Ad fontes, the status of the thyroid gland, and metabolic disturbance lead to the alteration of oxygenation. In pregnancy, it is particularly crucial to possess all predictive parameters. METHODS This cross-sectional study was conducted at the Clinic of Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, Serbia, between 2017 and 2021 which study included a total of 99 women who had been admitted for preterm delivery and had undergone thyroid analysis, detected Hashimoto thyroiditis, and Oral Glucose Tolerance Test (OGTT) 40 days after delivery and had pathological Homeostatic Model Assessment for Insulin Response (HOMA IR) indices. In the group of urgent patients with preterm delivery, we looked after not only routine Doppler of the umbilical artery, but we measured specific ratios such as the Cerebroplacental ratio (CP). RESULTS The mean maternal age was 32.23 ± 5.96 years and the mean gestational age was detected as 35.40 ± 2.39 weeks. The delivery was completed vaginally in 77 women (78%) and surgically in 22 (22%). The Mean APGAR score was 8.44 ± 1.18, the mean birth weight was 2666.87 ± 622.17g and the cases undergoing cesarean section had significantly higher values of pulsatility index (1.85 ± 0.27 vs. 1.34 ± 0.31) and CP (1.22 ± 0.26 vs. 0.47 ± 0.17). CONCLUSIONS The introduction of Doppler sonography for blood flow assessment helps to form a complete clinical description of the patient, particularly in conditions where oxidative stress became provocative by the thyroid gland antibodies and gestational diabetes in Thyroidology.
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Affiliation(s)
- Stefan Dugalic
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jovana Todorovic
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Demet Sengul
- Department of Pathology, Giresun University Faculty of Medicine, Giresun, Turkey
| | - Ilker Sengul
- Division of Endocrine Surgery, Giresun University Faculty of Medicine, Giresun, Turkey; Department of General Surgery, Giresun University Faculty of Medicine, Giresun, Turkey.
| | - Eduardo Carvalho de Arruda Veiga
- Department of Obstetrics and Gynecology, Universidade de São Paulo (FMRP-USP), Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, São Paulo, SP, Brazil
| | - Jovana Plesinac
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, Belgrade, Serbia
| | | | - Maja Macura
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, Belgrade, Serbia
| | | | - Miloš Milinčić
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, Belgrade, Serbia
| | - Andrija Pavlovic
- University of Belgrade, Faculty of Medicine, University Children Clinics, Belgrade, Serbia
| | - Miroslava Gojnic
- Clinic for Obstetrics and Gynecology, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Neonatal neuron specific enolase, a sensitive biochemical marker of neuronal damage, is increased in preeclampsia: A retrospective cohort study. Brain Dev 2020; 42:564-571. [PMID: 32417012 DOI: 10.1016/j.braindev.2020.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/06/2020] [Accepted: 04/26/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Preeclampsia leads to chronic intrauterine hypoxia by interfering with placental blood supply. We aimed to investigate whether preeclampsia exposure has an influence on central nervous system of infants, as evaluated by analyzing neonatal serum neuron specific enolase (NSE). METHODS This was a retrospective study including infants born in Nanfang hospital between Jan 2018 and Feb 2019 without asphyxia. They were divided into normotensive control group and preeclampsia group to compare the NSE levels. Furthermore, PE group was divided into five subgroups by lipstick of urine protein from 0 to 4+ to examine the relationship between urine protein and neonatal NSE. RESULTS Of the 86 selected neonates, there were 40 in control group and 46 in preeclampsia group. The NSE levels were significantly higher in infants with preeclampsia exposure compared to those infants in control group (45.504 ± 17.926 vs 30.690 ± 4.475, P < 0.0001). Multiple regression analyses revealed that the preeclampsia (β coef = 0.394, p = 0.041), 4+ proteinuria (β coef = 0.558, p < 0.0001) and 3+ proteinuria (β coef = 0.356, p = 0.005) were significant independent variables predicting elevated serum NSE concentration. CONCLUSION For the first time, this research has suggested the increase of neonatal NSE in preeclampsia, and the quantity of maternal proteinuria may be able to predict neonatal NSE elevation. Long-term neurodevelopmental follow-up and targeted preventive strategies are advised for this underrecognized high-risk population.
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Ferraro S, Braga F, Luksch R, Terenziani M, Caruso S, Panteghini M. Measurement of Serum Neuron-Specific Enolase in Neuroblastoma: Is There a Clinical Role? Clin Chem 2020; 66:667-675. [DOI: 10.1093/clinchem/hvaa073] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2020] [Indexed: 12/21/2022]
Abstract
Abstract
BACKGROUND
The measurement of neuron-specific enolase (NSE) in serum is frequently requested for diagnosis, risk stratification, and treatment monitoring of neuroblastoma (NB) in the pediatric population. However, authoritative clinical practice guidelines advise about the poor diagnostic performance of NSE.
Content
We critically appraised the available literature evaluating the diagnostic and prognostic value of NSE in the management of NB, paying special attention to the definition of appropriate threshold levels. In addition, we discuss the interfering conditions causing artifactual increases of NSE concentrations in serum and potentially influencing the clinical evaluation of patients with suspected NB.
Summary
No definitive evidence supports the use of serum NSE for diagnosis and monitoring of NB. The risk of obtaining false-positive NSE results associated with confounders (e.g., sample hemolysis) and other pathophysiologic conditions (e.g., inflammation) is remarkable and hampers the diagnostic value of this test. NSE may be helpful to define the risk of death of patients with NB, mainly in the advanced stages of disease. However, further studies validating currently marketed immunoassays and defining threshold values useful for this scope are warranted.
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Affiliation(s)
- Simona Ferraro
- Unità Operativa Complessa Patologia Clinica, ASST Fatebenefratelli-Sacco, Milano, Italy
| | - Federica Braga
- Unità Operativa Complessa Patologia Clinica, ASST Fatebenefratelli-Sacco, Milano, Italy
- Dipartimento di Scienze Biomediche e Cliniche, “Luigi Sacco,” Università degli Studi, Milano, Italy
| | - Roberto Luksch
- Struttura Complessa Pediatria Oncologica, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Monica Terenziani
- Struttura Complessa Pediatria Oncologica, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Simone Caruso
- Unità Operativa Complessa Patologia Clinica, ASST Fatebenefratelli-Sacco, Milano, Italy
| | - Mauro Panteghini
- Unità Operativa Complessa Patologia Clinica, ASST Fatebenefratelli-Sacco, Milano, Italy
- Dipartimento di Scienze Biomediche e Cliniche, “Luigi Sacco,” Università degli Studi, Milano, Italy
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Liu Q, Fan J, Xu A, Yao L, Li Y, Wang W, Liang W, Yang F. Distribution of serum neuron-specific enolase and the establishment of a population reference interval in healthy adults. J Clin Lab Anal 2019; 33:e22863. [PMID: 30779465 PMCID: PMC6595301 DOI: 10.1002/jcla.22863] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 01/26/2019] [Accepted: 01/30/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Neuron-specific enolase (NSE) is an important tumor marker in the serum of patients with lung cancer. Elevated serum NSE levels are also associated with many other diseases. However, there is no unified population reference interval for serum NSE. This study aimed to investigate the distribution of serum NSE in healthy Chinese adults aged 20-79 years and to establish its reference interval in Chinese population. METHODS A total of 10 575 healthy subjects were in line with the requirements of this study. The concentration of serum NSE was detected by a fully automated Cobas e602 analyzer with matching reagents. The population reference interval for serum NSE was established using the unilateral 95th percentile (P95 ) according to standard guidelines. RESULTS The distributions of serum NSE were not significantly different between males and females (P > 0.05) and also did not differ by age (P > 0.05). Therefore, the population reference interval for serum NSE was established as upper limit 25.4 ng/mL (90% confidence interval: 24.5-26.2 ng/mL). CONCLUSIONS We established the first population reference interval for serum NSE in a large healthy Chinese adult cohort, which was higher than that recommended by Roche Diagnostics GmbH. This new reference interval is more practical and applicable in Chinese adults.
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Affiliation(s)
- Qian Liu
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Jilong Fan
- Department of Hepatobiliary Surgery, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Aiguo Xu
- Department of Oncology, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Li Yao
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Yan Li
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Wenjun Wang
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Wei Liang
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China
| | - Fumeng Yang
- Department of Laboratory Medicine, The Second People's Hospital of Lianyungang, Lianyungang, China
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Georgantzi K, Sköldenberg EG, Stridsberg M, Kogner P, Jakobson Å, Janson ET, Christofferson RHB. Chromogranin A and neuron-specific enolase in neuroblastoma: Correlation to stage and prognostic factors. Pediatr Hematol Oncol 2018; 35:156-165. [PMID: 29737901 DOI: 10.1080/08880018.2018.1464087] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Chromogranin A (CgA) and neuron specific enolase (NSE) are important markers in adult neuroendocrine tumors (NET). Neuroblastoma (NB) has certain neuroendocrine properties. The aim of this study was to correlate blood concentrations of CgA, chromogranin B (CgB), and NSE to prognostic factors and outcome in children with NB. Blood samples from 92 patients with NB, 12 patients with benign ganglioneuroma (GN), 21 patients with non-NB solid tumors, 10 patients with acute leukemias, and 69 healthy children, were analyzed. CgA concentrations were higher in neonates vs. children older than one month in the control group (p < 0.0001), and in neonates with NB vs. the control group (p < 0.01). CgA and NSE concentrations were higher in patients with stages 3 and 4 disease (p < 0.05 and p < 0.05), in patients having tumors with amplification of MYCN (p < 0.05 and p < 0.001), or chromosome 1 p deletion (p < 0.05 and p < 0.05). NSE correlated to the tumor size at diagnosis (p < 0.001) and to tumor related death (p < 0.01) in NB. CgA and NSE concentrations were elevated in patients with NB and especially in those with advanced disease. Both CgA and NSE correlated to genetic markers, while only NSE correlated to primary tumor size and outcome in NB. We found that CgA and NSE are clinically valuable tumor markers in NB and they merit prospective clinical evaluations as such.
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Affiliation(s)
- Kleopatra Georgantzi
- a Department of Women's and Children's Health , Section of Pediatrics, University Children's Hospital , Uppsala , Sweden
| | - Erik G Sköldenberg
- b Department of Women's and Children's Health , Section of Pediatric Surgery, University Children's Hospital , Uppsala , Sweden
| | - Mats Stridsberg
- c Department of Clinical Chemistry , University Hospital , Uppsala , Sweden
| | - Per Kogner
- d Department of Women´s and Children´s Health , Karolinska University Hospital , Solna, Stockholm , Sweden
| | - Åke Jakobson
- a Department of Women's and Children's Health , Section of Pediatrics, University Children's Hospital , Uppsala , Sweden
| | - Eva Tiensuu Janson
- e Department of Medical Sciences , Uppsala University , Uppsala , Sweden
| | - Rolf H B Christofferson
- b Department of Women's and Children's Health , Section of Pediatric Surgery, University Children's Hospital , Uppsala , Sweden
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Thelin EP, Zeiler FA, Ercole A, Mondello S, Büki A, Bellander BM, Helmy A, Menon DK, Nelson DW. Serial Sampling of Serum Protein Biomarkers for Monitoring Human Traumatic Brain Injury Dynamics: A Systematic Review. Front Neurol 2017; 8:300. [PMID: 28717351 PMCID: PMC5494601 DOI: 10.3389/fneur.2017.00300] [Citation(s) in RCA: 161] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 06/12/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The proteins S100B, neuron-specific enolase (NSE), glial fibrillary acidic protein (GFAP), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), and neurofilament light (NF-L) have been serially sampled in serum of patients suffering from traumatic brain injury (TBI) in order to assess injury severity and tissue fate. We review the current literature of serum level dynamics of these proteins following TBI and used the term "effective half-life" (t1/2) in order to describe the "fall" rate in serum. MATERIALS AND METHODS Through searches on EMBASE, Medline, and Scopus, we looked for articles where these proteins had been serially sampled in serum in human TBI. We excluded animal studies, studies with only one presented sample and studies without neuroradiological examinations. RESULTS Following screening (10,389 papers), n = 122 papers were included. The proteins S100B (n = 66) and NSE (n = 27) were the two most frequent biomarkers that were serially sampled. For S100B in severe TBI, a majority of studies indicate a t1/2 of about 24 h, even if very early sampling in these patients reveals rapid decreases (1-2 h) though possibly of non-cerebral origin. In contrast, the t1/2 for NSE is comparably longer, ranging from 48 to 72 h in severe TBI cases. The protein GFAP (n = 18) appears to have t1/2 of about 24-48 h in severe TBI. The protein UCH-L1 (n = 9) presents a t1/2 around 7 h in mild TBI and about 10 h in severe. Frequent sampling of these proteins revealed different trajectories with persisting high serum levels, or secondary peaks, in patients with unfavorable outcome or in patients developing secondary detrimental events. Finally, NF-L (n = 2) only increased in the few studies available, suggesting a serum availability of >10 days. To date, automated assays are available for S100B and NSE making them faster and more practical to use. CONCLUSION Serial sampling of brain-specific proteins in serum reveals different temporal trajectories that should be acknowledged. Proteins with shorter serum availability, like S100B, may be superior to proteins such as NF-L in detection of secondary harmful events when monitoring patients with TBI.
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Affiliation(s)
- Eric Peter Thelin
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Frederick Adam Zeiler
- Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
- Department of Surgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Clinician Investigator Program, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Ari Ercole
- Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - András Büki
- Szentagothai Research Centre, University of Pecs, Pecs, Hungary
- Department of Neurosurgery, University of Pecs, Pecs, Hungary
- MTA-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary
| | | | - Adel Helmy
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - David K. Menon
- Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - David W. Nelson
- Section of Perioperative Medicine and Intensive Care, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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