Advertising Disclaimer
Published online August 25, 2008
PEDIATRICS Vol. 122 No. 3 September 2008, pp. e722-e727 (doi:10.1542/peds.2008-0269)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow View eLetters
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kumar, A.
Right arrow Articles by Basu, S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kumar, A.
Right arrow Articles by Basu, S.
Related Collections
Right arrow Premature & Newborn
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Free Radical Injury and Blood-Brain Barrier Permeability in Hypoxic-Ischemic Encephalopathy

Ashok Kumar, MDa, Roopali Mittal, MDb, Hari Dev Khanna, MDc, Sriparna Basu, MDa

a Division of Neonatology
b Department of Pediatrics
c Department of Biophysics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

OBJECTIVES. The purpose of this work was to evaluate the extent of free radical injury in newborns with hypoxic ischemic encephalopathy by measuring plasma levels of malondialdehyde and nitric oxide and to assess the blood-brain barrier permeability by measuring the cerebrospinal fluid albumin/plasma albumin ratio.

METHODS. This prospective observational study was conducted over a period of 2 years at Sir Sundarlal Hospital, Banaras Hindu University. The study population consisted of 43 term neonates with perinatal asphyxia who subsequently developed hypoxic ischemic encephalopathy. Twenty normal gestational age- and gender-matched healthy infants without any perinatal asphyxia served as control subjects. Peripheral venous blood samples were analyzed for malondialdehyde, total plasma nitrates/nitrites, and albumin levels between 12 and 24 hours of life. To assess the blood-brain barrier permeability, the cerebrospinal fluid albumin/plasma albumin ratio was measured. Correlation among the levels of malondialdehyde, nitrates/nitrites, and blood-brain barrier permeability was calculated. Data were analyzed by using SPSS 10 software.

RESULTS. Plasma malondialdehyde and nitrate/nitrite levels were significantly higher in infants with hypoxic ischemic encephalopathy compared with control subjects. Although there was a progressive increment in plasma levels of malondialdehyde with increasing severity of hypoxic ischemic encephalopathy, the differences were not statistically significant. Plasma nitrate/nitrite levels were almost similar in all stages of hypoxic ischemic encephalopathy. Plasma albumin levels were comparable in infants with hypoxic ischemic encephalopathy and control subjects, whereas cerebrospinal fluid albumin levels and blood-brain barrier permeability were significantly higher in infants with hypoxic ischemic encephalopathy. Significant correlation was observed between plasma malondialdehyde and nitrate/nitrite levels with blood-brain barrier permeability.

CONCLUSIONS. Increased plasma levels of malondialdehyde and nitrates/nitrites are found to be associated with hypoxic ischemic encephalopathy, indicating the possible role of free radical injury in its causation. Increased blood-brain barrier permeability may be another contributory factor to the progression of the disease.

Key Words: blood-brain barrier permeability • hypoxic ischemic encephalopathy • lipid peroxidation • malondialdehyde • newborn • nitric oxide • perinatal asphyxia

Abbreviations: HIE—hypoxic ischemic encephalopathy • NO—nitric oxide • BBB—blood-brain barrier • CSF—cerebrospinal fluid • SNK—Student-Newman-Keuls • NOS—nitric-oxide synthase • nNOS—neuronal nitric-oxide synthase • eNOS—endothelial nitric-oxide synthase • iNOS—inducible nitric-oxide synthase • VEGF—vascular endothelial growth factor

Accepted Apr 29, 2008.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Am. J. Physiol. Regul. Integr. Comp. Physiol.Home page
E. B. Yan, A. A. Baburamani, A. M. Walker, and D. W. Walker
Changes in cerebral blood flow, cerebral metabolites, and breathing movements in the sheep fetus following asphyxia produced by occlusion of the umbilical cord
Am J Physiol Regulatory Integrative Comp Physiol, July 1, 2009; 297(1): R60 - R69.
[Abstract] [Full Text] [PDF]

eLetters:

Read all eLetters

Reoxygenation after hypoxia
Heikki Savolainen
Pediatrics Online, 2 Sep 2008 [Full text]