Measurement of Lactate Content and Amide Proton Transfer Values in the Basal Ganglia of a Neonatal Piglet Hypoxic-Ischemic Brain Injury Model Using MRI

Yang, Zheng; Wang, X.-M.

doi:10.3174/ajnr.a5066

Cited by 30 publications

(19 citation statements)

References 51 publications

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“…In particular, the time of normalization of plasma lactate in cooled HIE babies showed a 23.1 h median value (range 2.9–73.5 h) in babies with good outcome and a 39.1 h median value (range 8.1–134.1 h) in the ones who survived with a poor outcome [ 39 ]. Moreover, a recent MR spectroscopy imaging study performed in a neonatal piglets hypoxic-ischemic brain injury model showed that, after the hypoxic-ischemic insult, the basal ganglia lactate content increase immediately, it reaches its maximum value at 2–6 hours, and then gradually decreases to the level of the control group [ 40 ]. In our sample, although all the babies were diagnosed with HIE Sarnat II-III and fulfil the criteria adopted from the Italian Recommendations for TH, urinary lactate relative concentration in HIE surviving newborns showed a similar trend over time whenever compared with healthy newborns, suggesting the existence of a wide variability either in the causes of HIE or in individual responses to hypoxic-ischemic insult.…”

Section: Discussionmentioning

confidence: 99%

A longitudinal 1H-NMR metabolomics analysis of urine from newborns with hypoxic-ischemic encephalopathy undergoing hypothermia therapy. Clinical and medical legal insights

et al. 2018

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Perinatal asphyxia is an event affecting around four million newborns worldwide. The 0.5 to 2 per 1000 of full term asphyxiated newborns suffer from hypoxic-ischemic encephalopathy (HIE), which is a frequent cause of death or severe disability and, as consequence, the most common birth injury claim for obstetrics, gynaecologists, and paediatricians. Perinatal asphyxia results from a compromised gas exchange that leads to hypoxemia, hypercapnia, and metabolic acidosis. In this work, we applied a metabolomics approach to investigate the metabolic profiles of urine samples collected from full term asphyxiated newborns with HIE undergoing therapeutic hypothermia (TH), with the aim of identifying a pattern of metabolites associated with HIE and to follow their modifications over time. Urine samples were collected from 10 HIE newborns at birth, during hypothermia (48 hours), at the end of the therapeutic treatment (72 hours), at 1 month of life, and compared with a matched control population of 16 healthy full term newborns. The metabolic profiles were investigated by 1H NMR spectroscopy coupled with multivariate statistical methods such as principal component analysis and orthogonal partial least square discriminant analysis. Multivariate analysis indicated significant differences between the urine samples of HIE and healthy newborns at birth. The altered metabolic patterns, mainly originated from the depletion of cellular energy and homeostasis, seem to constitute a characteristic of perinatal asphyxia. The HIE urine metabolome changes over time reflected either the effects of TH and the physiological growth of the newborns. Of interest, the urine metabolic profiles of the HIE non-surviving babies, characterized by the increased excretion of lactate, resulted significantly different from the rest of HIE population.

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Section: Discussionmentioning

confidence: 99%

A longitudinal 1H-NMR metabolomics analysis of urine from newborns with hypoxic-ischemic encephalopathy undergoing hypothermia therapy. Clinical and medical legal insights

et al. 2018

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“…Under this circumstance, lactate would, thus, be a less reliable predictive marker in the era of TH, unlike it used to be in untreated newborns. Moreover, a recent animal study has reported that the lactate content would become maximal at 2–6 h after the hypoxic-ischemic insult and then gradually decreased to the level of the control group even in normothermic models ( 28 ). Considering the time window and the duration of TH, it is probable that the relative concentration of lactate would not be sufficiently prognostic when performing 1 H-MRS scans.…”

Section: Discussionmentioning

confidence: 99%

Proton Magnetic Resonance Spectroscopy Biomarkers in Neonates With Hypoxic-Ischemic Encephalopathy: A Systematic Review and Meta-Analysis

et al. 2018

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Background: Hypoxic-ischemic encephalopathy (HIE) is a major contributor to child mortality and morbidity. Reliable prognostication for HIE is of key importance. Proton magnetic resonance spectroscopy (1H-MRS) is a quantitative, non-invasive method that has been demonstrated to be a suitable complementary tool for prediction. The aim of this study was to investigate the prognostic capability of 1H-MRS in the era of therapeutic hypothermia (TH).Methods: Databases, namely MEDLINE, Embase, Web of Science, and the Cochrane library (Cochrane Center Register of Controlled Trials), were searched for studies published before July 17, 2017. Study selection and data extraction were performed by two independent reviewers. The mean difference (MD) or standardized MD (SMD) and 95% confidence interval (CI) were calculated using random-effects models. Subgroup analyses were conducted based on the use of TH.Results: Among the 1,150 relevant studies, seven were included for meta-analysis, but only two small studies were conducted under TH. For 1H-MRS measurement, three peak area ratios revealed predictive values for adverse outcomes in TH subgroup and the combined results (with and without TH): N-acetylaspartate (NAA)/creatine in basal ganglia/thalamus (BG/T) in TH (MD −0.31, 95%CI −0.55 to −0.07) and combined results (MD −0.37, 95% CI −0.49 to −0.25); NAA/choline in BG/T in TH (MD −0.89, 95%CI −1.43 to −0.35) and combined results (MD −0.25, 95%CI −0.42 to −0.07); and myo-inositol/choline in cerebral cortex in TH (MD −1.94, 95%CI −3.69 to −0.19) and combined results (MD −1.64, 95%CI −2.64 to −0.64). Moreover, NAA relative concentration is associated with adverse outcomes: in TH (MD −0.04, 95%CI −0.06 to −0.02) and combined results (MD −0.06, 95%CI −0.11 to −0.01) in white matter; in TH (MD −0.04, 95%CI −0.07 to −0.01) and combined results (MD −0.05, 95%CI −0.07 to −0.02) in gray matter.Conclusions: NAA may be a potential marker in outcome prediction for all HIE subjects. It seems that MDs for the ratios including NAA are larger than for its relative concentration, and therefore are more likely to be measurable in a clinical context. Larger prospective multicenter studies with a standardized protocol for both measurement protocols and analysis methods are required in future studies.

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“…17 In the current study, the regulation mechanism of lactate and glucose after HI was investigated on the basis of the ANLS hypothesis. A high concentration of lactate or hypoxia can induce activation of glycolytic enzymes 18,19 and further upregulate MCTs. Immunohistochemical analyses showed that after HI, the expression levels of MCT-2 and MCT-4 also increased, peaked around 12-24 hours, and then decreased.…”

Section: Discussionmentioning

confidence: 99%

Expression Changes in Lactate and Glucose Metabolism and Associated Transporters in Basal Ganglia following Hypoxic-Ischemic Reperfusion Injury in Piglets

Yang

Wang

2018

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The neonatal brain has active energy metabolism, and glucose oxidation is the major energy source of brain tissue. Lactate is produced by astrocytes and released to neurons. In the central nervous system, lactate is transported between neurons and astrocytes via the astrocyte-neuron lactate shuttle. The aim of this study was to investigate the regulatory mechanisms of energy metabolism in neurons and astrocytes in the basal ganglia of a neonatal hypoxic-ischemic brain injury piglet model.

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Measurement of Lactate Content and Amide Proton Transfer Values in the Basal Ganglia of a Neonatal Piglet Hypoxic-Ischemic Brain Injury Model Using MRI

Cited by 30 publications

References 51 publications

A longitudinal 1H-NMR metabolomics analysis of urine from newborns with hypoxic-ischemic encephalopathy undergoing hypothermia therapy. Clinical and medical legal insights

A longitudinal 1H-NMR metabolomics analysis of urine from newborns with hypoxic-ischemic encephalopathy undergoing hypothermia therapy. Clinical and medical legal insights

Proton Magnetic Resonance Spectroscopy Biomarkers in Neonates With Hypoxic-Ischemic Encephalopathy: A Systematic Review and Meta-Analysis

Expression Changes in Lactate and Glucose Metabolism and Associated Transporters in Basal Ganglia following Hypoxic-Ischemic Reperfusion Injury in Piglets

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