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


1. Syrovaya LG, Shapoval VA, Makarov VN et al. (2014). Amino acids by the eyes of chemists, pharmacists, biologists. Kharkov, Shchedra sadiba plyus: 228.

2. Pipa LV, Svístíl'ník TV. (2013). Study of eksaytotoksychnyh amino acids on the degree of consciousness in purulent meningitis in children. Zdorov'ye rebenka. 4: 47.

3. Severin SYe. (2004). Biological Chemistry. 2nd ed., rev. Moskva, GEOTAR‒MED: 784. https://doi.org/10.1074/jbc.M401799200; PMid:15175347

4. Zozulya ÍS, Bobrova VÍ, M’yasnikova MP, Sich NS. (2010). A mill of neuroamic acids in the horns of the periodial infarction of the brain with cognitive impurities. Mezhdunarodnyy nevrologicheskiy zhurnal. 7(37).

5. Shabalov NP. (2004). Neonatology. Vols. 1-4. Moscow, MEDpress-inform: 608.

6. Punzo D, Errico F, Cristino L et al. (2016, Mar 9). Age-Related Changes in D-Aspartate Oxidase Promoter Methylation Control Extracellular D-Aspartate Levels and Prevent Precocious Cell Death during Brain Aging. J Neurosci. 36(10): 3064-78. https://doi.org/10.1523/JNEUROSCI.3881-15.2016

7. Mitra S, Bale G, Mathieson S et al. (2016, Aug 10). Changes in Cerebral Oxidative Metabolism during Neonatal Seizures Following Hypoxic-Ischemic Brain Injury. Front Pediatr. 4: 83. https://doi.org/10.3389/fped.2016.00083.

8. Brekke E, Berger HR, Widerøe M, Sonnewald U, Morken TS. (2017). Glucose and Intermediary Metabolism and Astrocyte-Neuron Interactions Following Neonatal Hypoxia-Ischemia in Rat. Neurochem Res. 42; 1: 115-132. https://doi.org/10.1007/s11064-016-2149-9.

9. Fuchs SA, Peeters-Scholte CM, de Barse MM, Roeleveld MW, Klomp LW et al. (2012). Increased concentrations of both NMDA receptor co-agonists D-serine and glycine in global ischemia: a potential novel treatment targetfor perinatal asphyxia. Amino Acids. 43; 1: 355-363. https://doi.org/10.1007/s00726-011-1086-9.

10. Zhu XY, Ma PS, Wu W, et al. 2016. Neuroprotective actions of taurine on hypoxic-ischemic brain damage in neonatal rats. J brainresbull. 124: 295-305. doi 10.101606.010.

11. Esih K, Goričar K, Dolžan V, Rener-Primec Z. (2016, Jun 2). The association between antioxidant enzyme polymorphisms and cerebral palsy after perinatal hypoxic-ischaemic encephalopathy. Eur J Paediatr Neurol. pii: S1090-3798(16)30075-7. doi 10.1016/j.ejpn.2016.05.018.

12. Zhang X.-M., Zhu J. (2011). Kainic acid-induced neurotoxicity: targeting glial responses and glia-derived cytokines. Current Neuropharmacology. 9: 388-398. https://doi.org/10.2174/157015911795596540; PMid:22131947 PMCid:PMC3131729

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