Neurofilament light chain associates with IVH and ROP in extremely preterm infants.

IF 3.1 3区 医学 Q1 PEDIATRICS Pediatric Research Pub Date : 2024-09-24 DOI:10.1038/s41390-024-03587-5
Ulrika Sjöbom, Annika Öhrfelt, Aldina Pivodic, Anders K Nilsson, Kaj Blennow, Henrik Zetterberg, William Hellström, Hanna Danielsson, Lotta Gränse, Karin Sävman, Dirk Wackernagel, Ingrid Hansen-Pupp, David Ley, Ann Hellström, Chatarina Löfqvist
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Abstract

Background: Neurofilament light chain (NfL) is known for indicating adult brain injury, but the role of NfL in extremely preterm infants is less studied. This study examines the relationship between NfL and neurovascular morbidities in these infants.

Methods: A secondary analysis of the Mega Donna Mega trial was conducted on preterm infants <28 weeks gestational age (GA). The study measured NfL levels and proteomic profiles related to the blood-brain barrier in serum from birth to term-equivalent age, investigating the association of NfL with GA, retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), and blood-brain barrier proteins.

Results: Higher NfL levels were seen in the first month in infants with severe IVH and for those born <25 weeks GA (independent of ROP or IVH). Additionally, infants born at 25-27 weeks GA with high NfL were at increased risk of developing severe ROP (independent of IVH). NfL was significantly associated with the proteins CDH5, ITGB1, and JAM-A during the first month.

Conclusion: NfL surges after birth in extremely preterm infants, particularly in those with severe IVH and ROP, and in the most immature infants regardless of IVH or ROP severity. These findings suggest NfL as a potential predictor of neonatal morbidities, warranting further validation studies.

Impact statement: This study shows that higher NfL levels are related to neurovascular morbidities in extremely preterm infants. The degree of immaturity seems important as infants born <25 weeks gestational age exhibited high postnatal serum NfL levels irrespective of neurovascular morbidities. Our findings suggest a potential link between NfL and neurovascular morbidities possibly affected by a more permeable blood-brain barrier.

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神经丝蛋白轻链与极早产儿IVH和ROP有关。
背景:众所周知,神经丝蛋白轻链(NfL)可指示成人脑损伤,但对 NfL 在极早产儿中的作用研究较少。本研究探讨了 NfL 与早产儿神经血管疾病之间的关系:对 Mega Donna Mega 试验的早产儿进行二次分析:患有严重IVH的婴儿和新生儿在出生后第一个月的NfL水平较高:极早产儿,尤其是患有严重 IVH 和早产儿视网膜病变的婴儿,以及发育最不成熟的婴儿,无论 IVH 或早产儿视网膜病变的严重程度如何,出生后 NfL 都会激增。这些发现表明,NfL 是预测新生儿发病率的潜在指标,值得进一步进行验证研究:本研究表明,较高的 NfL 水平与极早产儿的神经血管疾病有关。早产儿的不成熟程度似乎很重要。
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来源期刊
Pediatric Research
Pediatric Research 医学-小儿科
CiteScore
6.80
自引率
5.60%
发文量
473
审稿时长
3-8 weeks
期刊介绍: Pediatric Research publishes original papers, invited reviews, and commentaries on the etiologies of children''s diseases and disorders of development, extending from molecular biology to epidemiology. Use of model organisms and in vitro techniques relevant to developmental biology and medicine are acceptable, as are translational human studies
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