Asphyxia Associated Metabolite Biomarker Investigation (AAMBI). Short-term Clinical Outcomes And At The Age Of 22 To 42 Months

BACKGROUND AND PURPOSE: 

Perinatal hypoxic-ischemic encephalopathy (HIE) can be ameliorated by Therapeutic Hypothermia (TH) and potentially additionally by pharmacological neuroprotective interventions. Early identification of neonates at risk is not sufficiently reliable based on pH, base deficit, and APGAR scores. The AAMBI study aims to define a set of metabolomic biomarkers best suited to identify infants that might benefit from neuroprotective interventions. Here we present a comparison of neonatal short-term clinical outcomes of the AAMBI cohort with neurodevelopmental status at the age of 22 to 42 months (see Table 1). 

METHODOLOGY: 

Prospective observational study. Following written informed consent, three groups of infants were recruited: Group 1: 65 infants meeting local criteria for TH; Group 2: 38 infants with suspected perinatal brain injury based on moderate-to-severe perinatal acidosis (pH≤7.10 or a base excess ≤-12mmol/l) or resuscitation within 30min after birth but not undergoing TH; Group 3: 52 Infants with pH ≥ 7.25 and adaptation disorder of the newborn and need of postnatal clinical surveillance. The neonatal clinical outcome was determined based on Thompson Scores at 2±0.5h and 6±1h as well as results of central assessments of cMRI and aEEG and graded as normal, suspect, potentially abnormal, abnormal HIE, or abnormal non-HIE. In addition, results of the Bayley-Test and/or Ages and Stages Questionnaire (ASQ) and neurological assessment, as well as questions about visual and hearing capabilities, were used for outcome classification at 22-42 months graded normal, suspect, abnormal-HIE, and abnormal non-HIE. 

RESULTS: 

Figure 2 provides the distribution of inclusion groups to neonatal and 22-42 months neuro-developmental clinical outcomes. DISCUSSION AND CONCLUSION: For all three patient groups, the clinical diagnosis in the neonatal period does not allow a sufficiently reliable prognosis of the developmental status at 22-42 months. Therefore, classic diagnostic instruments commonly applied in the newborn period (e.g. pH) cannot reliably indicate the need for neuroprotective therapy. The AAMBI project aims to achieve improved diagnostic confidence by identifying metabolomic biomarkers. Therefore, blood samples assayed at birth and at 2 and 6h of age will now be subjected to a comprehensive metabolomic analysis.

Click to organic cistanche for ischemia-reperfusion injury 

The Mechanism of the Efficacy of Cistanche Herba in Treating Cerebral Ischemia-Reperfusion Injury

Cistanche is considered to have neuroprotective effects against cerebral ischemia-reperfusion injury. It is believed to exert its protective effects through several mechanisms including antioxidant activity, anti-apoptotic effects, and the modulation of inflammatory pathways. Some relevant tests that may be used to evaluate the efficacy of Cistanche in treating cerebral ischemia-reperfusion injury include neurological examination, histopathological analysis, and biochemical assays.

Several studies have explored the potential benefits of Cistanche in treating cerebral ischemia-reperfusion injury. One recent study published in the Journal of Ethnopharmacology in 2020 investigated the effects of Cistanche tubulosa extract on cerebral ischemia-reperfusion injury in rats. The study found that Cistanche tubulosa extract was able to improve neurological deficits and reduce neuronal damage in the rats.

Another study published in the journal Neural Regeneration Research in 2013 investigated the effects of Cistanche deserticola extract on cerebral ischemic-reperfusion injury in rats. The study found that Cistanche deserticola extract was able to reduce oxidative stress and inflammation in the rats, leading to improved neurological outcomes.

While the results of these studies suggest that Cistanche may have potential benefits in treating cerebral ischemia-reperfusion injury, more research is needed to fully evaluate its therapeutic potential.