The impact of therapeutic hypothermia on peripheral blood cell in newborns with hypoxic ischemic encephalopathy

Authors

  • Abdullah Kurt Department of Pediatrics Division of Neonatology https://orcid.org/0000-0002-4430-444X
  • Ayşegül Zenciroğlu Department of Pediatrics Division of Neonatology, Sağlık Bilimleri University, Dr Sami Ulus Maternity and Children Research and Training Hospital, Ankara,Turkey
  • Hasan Akduman Department of Pediatrics Division of Neonatology, Sağlık Bilimleri University, Dr Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey

DOI:

https://doi.org/10.1590/s2175-97902022e181053

Keywords:

Hypoxic ischemic encephalopathy, Inflammation, Newborn

Abstract

The effect of hypothermia treatment on white blood cell (WBC), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) values as an indicator of inflammation was evaluated in newborns with hypoxic ischemic encephalopathy (HIE). The study was performed that the before-therapeutic hypothermia (TH) and after-TH WBC, lymphocytes, neutrophils, monocytes and NLR, LMR and PLR values of the complete blood cell count were retrospectively evaluated. The results of the patient group were compared with the results of healthy newborns. A total of 78 patients who underwent TH were evaluated in our study. Mean values before and after TH were NLR3.8/2.7, LMR 5.6/8.6, and PLR 60.3/67.1 respectively. A statistical significance was present for NLR values before and after TH in those with seizure in our study (4.15±2.95/3.01±2.54) but no statistical significance was found for LMR or PLR. In neonates with HIE, effect of TH on complete blood cell count and inflammatory mechanisms (mediated neutrophil and lymphocyte) may be minimal.

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References

Algra SO, Groeneveld KM, Schadenberg AW, Haas F, Evens FC, Meerding J et al. Cerebral ischemia initiates an immediate innate immune response in neonates during cardiac surgery. J Neuroinflammation. 2013;10:24.

Benjelloun N, Renolleau S, Represa A, Ben-Ari Y, Charriaut-Marlangue C. Inflammatory responses in the cerebral cortex after ischemia in the P7 neonatal Rat. Stroke. 1999;30(9):1916-1923 discussion 1923-1924.

Brait VH, Jackman KA, Walduck AK, Selemidis S, Diep H, Mast AE et al. Mechanisms contributing to cerebral infarct size after stroke: gender reperfusion, T lymphocytes, and Nox2-derived superoxide. J Cereb Blood Flow Metab. 2010;30(7):1306-1317.

Cheong JL, Coleman L, Hunt RW, Lee KJ, Doyle LW, Inder TE et al. Prognostic utility of magnetic resonance imaging in neonatal hypoxic-ischemic encephalopathy: sub study of a randomized trial. Arch Pediatr Adolesc Med. 2012;166(7):634-640.

Douglas-Escobar M, Weiss MD. Hypoxic-ischemic encephalopathy: a review for the clinician. JAMA Pediatr. 2015;169(4):397-403.

Doycheva DM, Hadley T, Li L, Applegate RL, Zhang JH, Tang J. Anti-neutrophil antibody enhances the neuroprotective effects of G-CSF by decreasing number of neutrophils in hypoxic ischemic neonatal rat model. Neurobiol Dis. 2014;69:192-199.

Hudome S, Palmer C, Roberts RL, Mauger D, Housman C, Towfighi J. The role of neutrophils in the production of hypoxic-ischemic brain injury in the neonatal rat. Pediatr Res. 1997;41:607-616.

Hurn PD, Subramanian S, Parker SM, Afentoulis ME, Kaler LJ, Vandenbark AA et al. T- and B-cell-deficient mice with experimental stroke have reduced lesion size and inflammation. J Cereb Blood Flow Metab. 2007;27:1798-1805.

Hu YX, Xu XX, Shao Y, Yuan GL, Mei F, Zhou Q et al. The prognostic value of lymphocyte-to-monocyte ratio in retinopathy of prematurity. Int J Ophthalmol. 2017;10(11):1716- 1721.

Jenkins DD, Lee T, Chiuzan C, Perkel JK, Rollins LG, Wagner CL et al. Altered circulating leukocytes and their chemokines in a clinical trial of therapeutic hypothermia for neonatal hypoxic ischemic encephalopathy. Pediatr Crit Care Med. 2013;14(8):786-795.

Joy R, Pournami F, Bethou A, Bhat VB, Bobby Z. Effect of therapeutic hypothermia on oxidative stress and outcome in term neonates with perinatal asphyxia: a randomized controlled trial. J Trop Pediatr. 2013;59(1):17-22.

Lambert RM, Baer VL, Wiedmeier SE, Henry E, Burnett J, Christensen RD. Isolated elevated blood neutrophil concentration at altitude does not require NICU admission if appropriate reference ranges are used. J Perinatol. 2009;29(12):822-825.

Li B, Concepcion K, Meng X, Zhang L. Brain-immune interactions in perinatal hypoxic-ischemic brain injury. Progr Neurobiol. 2017;159:50-68.

Liu F, McCullough LD. Inflammatory responses in hypoxic ischemic encephalopathy. Acta Pharmacol Sin. 2013;34(9):1121-30.

Morkos AA, Hopper AO, Deming DD, Yellon SM, Wycliffe N, Ashwal S et al. Elevated total peripheral leukocyte count may identify risk for neurological disability in asphyxiated term neonates. J Perinatol. 2007;27(6):365-370.

Naess A, Nilssen SS, Mo R, Eide GE, Sjursen H. Role of neutrophil to lymphocyte and monocyte to lymphocyte ratios in the diagnosis of bacterial infection in patients with fever. Infection. 2017;45(3):299-307.

Naeye RL, Shaffer ML. Postnatal laboratory timers of antenatal hypoxemic-ıschemic brain damage. J Perinatol. 2005;25(10):664-668.

Nakajima W, Ishida A, Lange MS, Gabrielson KL, Wilson MA, Martin LJ et al. Apoptosis has a prolonged role in the neurodegeneration after hypoxic ischemia in the newborn rat. J Neurosci. 2000;20(20):7994-8004.

Nelson KB. The epidemiology of cerebralpalsy in term infants. Ment Retard Dev Disabil Res Rev. 2002;8(3):146-150.

Palmer C, Roberts RL, Young PI. Timing of neutrophil depletion influences long-term neuroprotection in neonatal rat hypoxic-ischemic brain injury. Pediatr Res. 2004;55(4):549-556.

Papile LA, Baley JE, Benitz W, Cummings J, Carlo WA, Eichenwald E et al. Hypothermia and neonatal encephalopathy. Pediatrics. 2014;133(6):1146-1150.

Rocha-Ferreira E, Hristova M. Plasticity in the neonatal brain following hypoxic-ischaemic injury. Neural Plas. 2016;2016:4901014.

Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol. 1976;33(10):696-705.

Shankaran S, Woldt E, Koepke T, Bedard MP, Nandyal R. Acute neonatal morbidity and long-term central nervous system sequelae of perinatal asphyxia in term infants. Early Hum Dev. 1991;25(2):135-148.

Wang J, Lu Q. Expression of T subsets and mIL-2R in peripheral blood of newborns with hypoxic ischemic encephalopathy. World J Pediatr. 2008;4(2):140-144.

Winerdal M, Winerdal ME, Kinn J, Urmaliya V, Winqvist O, Aden U. Long lasting local and systemic inflammation after cerebral hypoxic ischemia in newborn mice. PLoS One. 2012;7(5):e36422.

Winerdal M, Winerdal ME, Wang YQ, Fredholm BB, Winqvist O, Aden U. Adenosine A1 receptors contribute to immune regulation after neonatal hypoxic ischemic brain injury. Purinergic Signal. 2016;12(1):89-101.

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Published

2022-11-10

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Original Article

How to Cite

The impact of therapeutic hypothermia on peripheral blood cell in newborns with hypoxic ischemic encephalopathy. (2022). Brazilian Journal of Pharmaceutical Sciences, 58. https://doi.org/10.1590/s2175-97902022e181053