Endothelial Dysfunction and Intestinal Barrier Injury in Preterm Infants with Perinatal Asphyxia

Abstract

Perinatal asphyxia is one of the most frequent causes of perinatal morbidity, accounting for approximately 23% of neonatal deaths worldwide. Fetuses that suffer from hypoxia-ischemia are at high risk of developing multiorgan dysfunction, including the gut. Hypoxie-induced gut injury may result in adverse clinical outcomes, such as feeding intolerance and necrotizing enterocolitis. Increased permeability and subsequently an enhanced entry of bacteria and endotoxins into the systemic circulation can contribute to endotoxin aggression and further trigger numerous diseases. The aim of study is to investigate the effect of perinatal asphyxia on the integrity of the intestinal barrier and the state of antiendotoxin immunity. The study included preterm neonates exposed to perinatal asphyxia, who were comparable with non-asphyxiated infants. The concentrations of intestinal mucosa barrier injury markers (intestinal fatty acid binding protein, liver fatty acid protein, lipopolysaccharide binding protein), neurospecific proteins (neurospesific enolase, NR-2 antibodies), and also endothelial dysfunction markers (endothelin-1, nitric oxide) were determined in serum of included neonates on day of 1 and 7. The high risk of intestinal mucosal injury in newborn exposed to perinatal asphyxia decreases the level of antiendotoxic immunity and should be considered as an unfavorable factor for sepsis.