Iron metabolism and lipid peroxidation products in infants with hypoxic ischemic encephalopathy

Abstract

Background: Iron delocalization or misregulation of iron metabolism may play a critical role in the pathology of hypoxic ischemic encephalopathy (HIE).Objective: To study iron metabolism and lipid peroxidation in newborn infants and to correlate non-protein-bound iron (NPBI) concentration with the severity of the post-asphyxial injury and subsequent short-term outcomes.Study Design: Concentrations of NPBI and malondialdehyde (MDA) in the serum and in the cerebrospinal fluid (CSF) were measured in eight healthy newborn infants and nine newborn infants suffering from moderately severe HIE. Short-term outcomes (death, survival with or without neurological abnormality) were noted at hospital discharge.Result: Serum and CSF concentrations of both NPBI and MDA were significantly increased in HIE infants when compared to controls. Serum iron was significantly increased and total iron binding capacity was significantly decreased in HIE infants compared to controls. Out of the nine HIE infants, four infants died and two infants survived with abnormal neurological findings at hospital discharge. These six infants with clinical sequels had significantly increased concentrations of NPBI in the serum and in the CSF; and increased concentrations of MDA in the CSF when compared to the other three who survived without short-term abnormalities. Conclusion:We conclude that hypoxia ischemia alters iron metabolism and lipid peroxidation in newborn infants; and that NPBI and MDA in the CSF are increased in infants with HIE. This study supports a role for iron in oxidative injury to the central nervous system after hypoxic ischemic insults.

Preliminary case control study to establish the correlation between novel peroxidation biomarkers in cord serum and the severity of hypoxic ischemic encephalopathy

“…Moreover, metabolite levels correlated with the severity of HIE [33]. Shouman et al [34] also found increased NPBI and MDA CSF and serum levels in babies with asphyxia evolving to HIE, and established a correlation between clinical severity and metabolite concentration. Brain tissue is especially rich in lipid components in their cell membranes.…”

Actualities on molecular pathogenesis and repairing processes of cerebral damage in perinatal hypoxic-ischemic encephalopathy

“…The formation of free-radicals, some being highly reactive such as hydroxyl radical, in addition to oxygen is also supported by a major haematic concentration of free iron due to hypoxia-induced acidosis that is known to detach the iron bonded in circle to transferrine [10]. These oxidative processes, in fact, can be blocked by deferoxamine, an iron-chelator that experimental studies in lambs have shown capable of preserving cortical cells membrane stability and electrocortical brain activity when used during early reperfusion after H-I insult [11].…”

Lipid peroxides in the serum of asphyxiated neonates

“…Of note, a small pilot study has previously associated serum with CSF concentrations of LPO. 15 We did not discover data to support the similarity of LPOs in cord blood and serum samples, consequently we opted not to use cord blood samples for LPO assessment in the control group as a surrogate for serum blood concentrations. However, we spent the effort to coordinate blood sampling with other tests prescribed for their individual care whenever applicable to minimize insensitivity to these newborns.…”

“…15 To detect an increase in the asphyxia group by 20%, a sample of 38 per group will be required. To detect an extra 50% increase in LPO concentrations in non-survivors, at least 5 non-survivors within the asphyxia group will be required.…”