2024-02-20 14:55:32
Blood test identifies cause of brain injury in newborns
By the LabMedica editorial team in Spanish
Updated on Feb 20, 2024
Hypoxic-ischemic encephalopathy (HIE), also known as birth asphyxia, is a brain injury that occurs when a newborn’s brain does not receive enough oxygen before or just following birth. This condition is a leading cause of death and disability in full-term babies worldwide, affecting regarding three million babies a year. Brain damage caused by lack of oxygen can develop over a period of hours to months, which can affect various areas of the brain and lead to various neurodisabilities, such as cerebral palsy, epilepsy, and sensory impairments such as deafness or blindness. South Asia, especially India, is the most affected by this problem: 60% of HIE-related deaths globally occur in that country. Now, a blood test can identify the underlying cause of brain injury in newborns and help make informed treatment decisions.
In a study of babies with HIE, researchers at Imperial College London (London, United Kingdom) found that gene expression patterns in the blood can indicate the source of the lesion and predict the likelihood that the baby will respond to cooling treatment , a common method of treating brain injuries in babies. This advance might pave the way for a simple blood test that quickly diagnoses brain injuries in newborns and aids in treatment decisions. The research included infants from low- and middle-income countries (LMIC) and high-income countries (HIC), revealing a stark contrast in gene expression between these groups, suggesting different causes of brain injury.
Image: Blood test might reveal cause of brain injury in newborns (Photo courtesy of Colegio Imperial)
Previous research, primarily in PIA, has shown that whole-body cooling can improve the recovery prospects of babies with HIE. This has led to its widespread adoption as standard practice in many PIAs and some South Asian hospitals. However, the largest study of its kind in LMICs, conducted by Imperial College London and partners in India, Bangladesh and Sri Lanka, had previously found that whole-body cooling might actually worsen outcomes and increase mortality risks in infants with HIE in these regions. The new study sheds light on why babies from different regions respond differently to cooling treatment and has the potential for the development of a simple blood test to identify which babies will benefit from it. The research, a collaboration between Imperial College London and its South Asian partners, involved 35 Italian (one PIA) and 99 South Asian (LMIC) newborns with HIE. Blood samples were collected shortly following birth and the babies were medically evaluated at 18 months.
About half of the babies in the South Asian group died or developed serious disabilities, compared with a quarter in the Italian group. The researchers analyzed the correlation between gene expression at birth and outcomes at 18 months in both groups. They identified 1,793 major genes linked to adverse outcomes in the PIA group and 99 in the South Asian group, with only 11 major genes common to both groups but expressed differently. The researchers emphasized that these differences are not due to ethnic but socioeconomic factors. The type of chronic brain injury common in LMICs can also be found in impoverished areas of HICs. In contrast, in wealthier regions of LMICs, more cases of acute brain injury might be found, similar to those typically seen in LMICs in this study.
“The key for doctors, anywhere in the world, is to be able to identify the type of brain injury they are dealing with as early as possible, and that is something we are currently working on,” said lead researcher Professor Sudhin. Thayyil from the Department of Brain Sciences at Imperial College London.
Related links:
Imperial College London
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