• Metabolic changes of amino acids in perinatal hypoxic-ischemic encephalopathy and their dependence on the severity of morphological changes in the brain according to neurosonography

Metabolic changes of amino acids in perinatal hypoxic-ischemic encephalopathy and their dependence on the severity of morphological changes in the brain according to neurosonography

PERINATOLOGIYA I PEDIATRIYA. 2017.2(70):102-107; doi 10.15574/PP.2017.70.102

Yanovskaya G. O., Grechanina О. Ya., Grechanina Yu. B., Zdybskaya О. P.
Kharkov National Medical University, Ukraine

Purpose — to study changes in blood amino acid levels in hypoxic-ischemic encephalopathy, depending on the severity of morphological changes in the brain.

Materials and methods. A total of 60 newborns in the acute period of hypoxic-ischemic encephalopathy and 17 relatively healthy newborns were examined; a study of blood free amino acids, neurosonography were performed.

Results. In neonates with hypoxic-ischemic encephalopathy, the levels of glutamate, glycine, whose participation in the pathogenesis of hypoxic-ischemic encephalopathy has been proven, as well as methionine and amino acid, which participate in energy metabolism and maintain a constant blood glucose level: alanine, valine, threonine, leucine, were more often significantly increased. Reduced levels were more often of tryptophan and tyrosine, which can be a substrate for the synthesis of neurotransmitters. The dependence of changes in amino acids on the severity of morphological changes in the brain was revealed: in periventricular ischemia of a mild degree, the levels of threonine, isoleucine and valine more often increased; probably, this is the result of their participation in the energy metabolism and gluconeogenesis, and demonstrates the work of compensatory mechanisms in response to hypoxia. In patients with severe periventricular ischemia, the levels of tyrosine, tryptophan, threonine, isoleucine, and histidine significantly more often decreased, which may be the result of "depletion" of energy and neurotransmitter metabolism, and/or increased need.

Conclusions. Our data confirms the active participation of amino acids in pathogenesis and mechanisms of compensation for hypoxic-ischemic encephalopathy. The amino acids involved in the processes of neurotransmission and energy metabolism were most often changed. The revealed changes in the amino acids in the case of a severe hypoxic-ischemic encephalopathy can indicate the depletion of these processes.

Key words: hypoxic-ischemic encephalopathy, amino acids, neurosonography.

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