[Frontiers in Bioscience E2, 36-42, January 1, 2010]

Activin A in asphyxiated full-term newborns with hypoxic ischemic encephalopathy

Pasquale Florio1, Alessandro Frigiola2, Raffaele Battista1, Ali El Hadi Abdalla1, Diego Gazzolo3, Letizia Galleri1, Serena Pinzauti1, Raul Abella2, Giovanni Li Volti4, Mirella Strambi1, Felice Petraglia1

1Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy, 2Department of Cardiac Surgery, S. Donato Milanese University Hospital, San Donato Milanese, Italy, 3Neonatal Intensive Care Unit, "Cesare Arrigo" Children Hospital, Alessandria, Italy, Perinatal Research Laboratory, 4Department of Biochemistry, University of Catania, Catania, Italy

TABLE OF CONTENTS

1. Abstract
2. Introduction
3. Materials and methods
3.1. Patients
3.1.1. Cranial assessment
3.1.2. Neurodevelopmental outcome
3.2. Activin A assay
3.3. Statistical analysis
4. Results
4.1. Clinical findings
4.2. Serum activin A levels and the prediction of HIE
5. Discussion
6. Acknowledgements
7. References

1. ABSTRACT

Activin-A is a protein over-expressed and secreted by the brain after neuronal destruction. We evaluated whether serum activin-A increases in asphyxiated full-term newborns (AFTNs) at risk of hypoxic-ischemic-encephalopathy (HIE). 105 consecutive infants (35 affected by perinatal asphyxia due to acute fetal distress; 70 healthy gestational-age matched newborns) underwent cranial assessment and neurologic examination at 12, 24 and 72 hours after birth and, on discharge from the hospital and; activin-A and monitoring laboratory variables assessment at birth. According to the occurrence of HIE within 7-days after birth, AFTNs were subdivided in Group A (n= 20; no/mild HIE with good prognosis) and Group B (n= 15; moderate/severe HIE with a greater risk of neurological handicap). Activin-A was significantly (P less than 0.0001) higher in Groups A and B than controls and highest (P less than 0.001) in Group B. At 0.66 ng/L activin-A achieved a sensitivity of 93.33% and a specificity of 96.63%, respectively, as HIE diagnostic test. These findings show that activin A increased in AFTNs with HIE before the appearance of related signs.