Abstract
Objectives
The early detection and stratification of asphyxiated infants at higher risk for impaired neurodevelopment is challenging. S100B protein is a well-established biomarker of brain damage, but lacks conclusive validation according to the “gold standard” methodology for hypoxic-ischemic encephalopathy (HIE) prognostication, i.e. brain MRI. The aim of the present study was to investigate the predictive role of urinary S100B concentrations, assessed in a cohort of HIE infants receiving therapeutic hypothermia (TH), compared to brain MRI.
Methods
Assessment of urine S100B concentrations was performed by immunoluminometric assay at first void and at 4, 8, 12, 16, 20, 24, 48, 72, 96, 108 and 120-h after birth. Neurologic evaluation, routine laboratory parameters, amplitude-integrated electroencephalography, and cerebral ultrasound were performed according to standard protocols. Brain MRI was performed at 7–10 days of life.
Results
Overall, 74 HIE neonates receiving TH were included in the study. S100B correlated, already at first void, with the MRI patterns with higher concentrations in infants with the most severe MRI lesions.
Conclusions
High S100B urine levels soon after birth constitute trustable predictors of brain injury as confirmed by MRI. Results support the reliability of S100B in clinical daily practice and open the way to its inclusion in the panel of parameters used for the selection of cases suitable for TH treatment.
Funding source: Diasorin, Saluggia – Italy
Funding source: I colori della vita Foundation
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Research funding: This work is part of the I.O. PhD International Program under the auspices of the Italian Society of Neonatology and was partially supported by grants to DG from “I Colori della Vita Foundation”, Italy. We thank Diasorin, Saluggia, Italy, for supporting analysis kits.
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Author contributions: Iliana Bersani, Giorgia Gasparroni, Bashir Moataza, Hanna Aboulgar, Hala Mufeed, Iman Iskander, Maria Kornacka, Darek Gruzfeld, Andrea Dotta, Francesca Campi, Daniela Longo, Immacolata Savarese, Annabella Braguglia, Lucia Gabriella Tina, Francesco Nigro, Laura Serpero, Maria Chiara Strozzi, Antonio Maconi, Patrizia Ianniello, Caterina Di Battista, Ebe D’Adamo and Danilo Gavilanes contributed to the conceptualization, investigation and writing of the original draft. Diego Gazzolo and Iliana Bersani contributed to the project administration, conceptualization, investigation, supervision and writing – review and editing. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all subjects’ parents involved in the study. Written informed consent was obtained from all subjects’ parents to publish the paper.
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Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013). The Local Ethic Committees of the Cooperative Multitask against Brain Injury of Neonates (CoMBINe) International Network approved the study protocol.
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Data availability: All data will be made available upon request. Please contact the corresponding author.
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