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Am J Perinatol 2022; 39(12): 1367-1374
DOI: 10.1055/s-0040-1722601
Original Article

Effect of Hypothermia on Serum Myelin Basic Protein and Tumor Necrosis Factor–α in Neonatal Hypoxic-Ischemic Encephalopathy

Qiuli Wang
1   Department of Neonatology, Handan Maternal and Child Health Care Hospital, Handan, Hebei Province, People's Republic of China
,
Hongyan Lv
1   Department of Neonatology, Handan Maternal and Child Health Care Hospital, Handan, Hebei Province, People's Republic of China
2   Department of Neonatal Pathology, Handan Maternal and Child Health Care Hospital, Handan, Hebei Province, People's Republic of China
,
Sujing Wu
1   Department of Neonatology, Handan Maternal and Child Health Care Hospital, Handan, Hebei Province, People's Republic of China
,
Junxia Song
1   Department of Neonatology, Handan Maternal and Child Health Care Hospital, Handan, Hebei Province, People's Republic of China
,
Junqin Li
1   Department of Neonatology, Handan Maternal and Child Health Care Hospital, Handan, Hebei Province, People's Republic of China
,
Haihua Huo
1   Department of Neonatology, Handan Maternal and Child Health Care Hospital, Handan, Hebei Province, People's Republic of China
,
Pengshun Ren
1   Department of Neonatology, Handan Maternal and Child Health Care Hospital, Handan, Hebei Province, People's Republic of China
,
Lianxiang Li
2   Department of Neonatal Pathology, Handan Maternal and Child Health Care Hospital, Handan, Hebei Province, People's Republic of China
3   Department of Neural Development and Neural Pathology, Hebei University of Engineering School of Medicine, Handan, Hebei Province, People's Republic of China
› Author Affiliations Funding This study was supported by Health and Family Planning Commission of Hebei (20150033); Science and Technology Department of Hebei Province (172777209).
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Abstract

Objective Multiple randomized controlled trials have shown that hypothermia is a safe and effective treatment for neonatal moderate or severe hypoxic-ischemic encephalopathy (HIE). The neuroprotective mechanisms of hypothermia need further study. The aim of this study was to investigate the effect of hypothermia on the serum levels of myelin basic protein (MBP) and tumor necrosis factor-α (TNF-α) as well as neurodevelopmental outcomes in neonatal HIE.

Study Design Eighty-five neonates with moderate-to-severe HIE were divided into a hypothermia group (n = 49) and a control group (n = 36). Serum levels of MBP and TNF-α within 6 hours after birth and after 3 days of treatment were determined by enzyme-linked immunosorbent assay, and neurodevelopmental outcome at the age of 12 to 15 months was assessed by using the Gesell development scale.

Results After 3 days of treatment, serum levels of MBP and TNF-α in the control group were not significantly different from levels before treatment (p > 0.05), and serum levels of MBP and TNF-α in the hypothermia group were significantly lower than levels before treatment (p < 0.05). Serum levels of MBP and TNF-α were significantly negatively correlated with developmental quotient (DQ; r =  − 0.7945, p = 0.0000; r =  − 0.7035, p = 0.0000, respectively). Serum levels of MBP and TNF-α in neurodevelopmentally impaired infants were significantly higher than those in infants with suspected neurodevelopmental impairment and those in neurodevelopmentally normal infants (both p < 0.01). The rate of reduction of neurodevelopmental impairment was higher among infants in the hypothermia group than among those in the control group (χ2 = 16.3900, p < 0.05).

Conclusion Hypothermia can reduce serum levels of MBP and TNF-α in neonates with HIE. Inhibiting the release of TNF-α may be one of the mechanisms by which hypothermia protects the myelin sheath.

Key Points

  • Hypothermia can reduce serum levels of MBP and TNF-α in neonatal HIE.

  • Hypothermia improves neurodevelopmental outcomes and reduces the rate of neurodevelopmental impairment.

  • Hypothermia is a feasible and effective treatment for neonates with moderate or severe HIE.

Keywords

neonatal hypoxic-ischemic encephalopathy - hypothermia - myelin basic protein - tumor necrosis factor-α - neuroprotective mechanisms


Publication History

Received: 05 May 2020

Accepted: 02 December 2020

Article published online:
17 January 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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