Promising biomarkers of blood-brain barrier permeability impairment in rehabilitation of infants with perinatal hypoxic-ischemic central nervous system injury

Abstract

Background. Diagnostics, treatment and rehabilitation of newborns with injury of the central nervous system (CNS) tissues are one of the pressing problems of contemporary medical community. Early diagnostics of hypoxic-ischemic damage to CNS tissues is a key element in the strategy of supporting newborns with asphyxia. The search for sensitive and specific diagnostic tools will improve the prognosis of disease outcome and the effectiveness of rehabilitation.Objective: to identify promising serum biomarkers of brain tissue damage for screening and monitoring in neonates.Material and methods. The search for publications was carried out automatically in scientific databases (PubMed/MEDLINE, Google Scholar, ScienceDirect) and electronic library (eLibrary) as well as manually in search engines (Yandex, Google). The subsequent selection of articles was carried out according to PRISMA recommendations. Of 3778 publications found, 52 were included in the review.Results. The promising biomarkers of brain injury determined in the blood serum of newborns were detected: dipeptidyl peptidase 4, a number of cytokines, neuron-specific enolase (NSE), butylcarnitine, calcium-binding protein B S100 (S100B), F2-isoprostanes, nucleated erythrocytes, and some other biomarkers, the change in the level of which correlated with the severity of CNS tissue damage.Conclusion. Blood-brain barrier dysfunction causes the appearance of highly specific proteins of neuronal and glial injury, in particular S100B and NSE, in blood serum, which can be determined as biomarkers. It is necessary to expand the evidence base and validation of using the mentioned biomarkers for subsequent implementation in clinical guidelines on managing patients with CNS tissue damage in the early postnatal period for timely diagnosis and correction of rehabilitation measures.