• Changes of the amino acid metabolism in hypoxic-ischemic encephalopathy and their dependence on clinical symptoms

Changes of the amino acid metabolism in hypoxic-ischemic encephalopathy and their dependence on clinical symptoms

SOVREMENNAYA PEDIATRIYA.2017.4(84):112-116; doi 10.15574/SP.2017.84.112

Yanovska А. A., Grechanina E. Ya., Grechanina Yu. B.
Kharkiv National Medical University, Ukraine

Objective. To study the changes of amino acid levels in hypoxic-ischemic encephalopathy (HIE), depending on the severity of clinical symptoms.

Materials and methods. The study involved 117 infants with HIE and 35 relatively healthy newborns. The detection of the serum free amino acids by using a high-performance liquid chromatography was performed in all patients.

Results. During the acute period of HIE, a level increase of glutamate and glycine was determined that corresponds to the literature data, and methionine and amino acids, involved in energy metabolism and maintenance of a constant level of blood glucose, such as alanine, threonine, valine, leucine, as well. Besides, the decreased levels of tryptophan and tyrosine, which are precursors of neurotransmitters, were observed. In the early recovery period of HIE, in comparison with the acute period, the frequent changes of the urea cycle amino acids, aspartate, and the decreased level of valine were diagnosed. The changes of amino acids differed depending on the course of the HIE. Thus, in case of seizures, the reduced tryptophan and elevated aspartate levels were often observed, and in the early recovery period, the level of tyrosine was usually reduced. In children with brain edema, a decreased aspartate and tryptophan levels were frequently detected. On the CNS depression syndrome, in its acute period, there were often reduced citrulline, as opposed to the levels of methionine and arginine that were changed less frequently. The excitation syndrome was often accompanied by the raised cysteine and taurine levels.

Conclusions. The identified data suggest that the metabolism of amino acids plays one of the leading roles in the pathogenesis of HIE. The most commonly identified changes occurred in the levels of amino acid that are involved in neurotransmission processes, energy metabolism, and detoxification of ammonia. The research results give grounds for metabolic correction and prevention of complications.

Keywords: perinatal affection, hypoxic-ischemic encephalopathy, amino acids.


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