Impaired structural and functional properties of hemoglobin in the pathogenesis of fetal and neonatal hypoxia
Objective. To investigate major risk factors of fetal and neonatal hypoxia and the role of the impaired structural and functional state of hemoglobin in its pathogenesis.Marusov A.P., Ledyaikina L.V., Balykova L.A., Gerasimenko A.V., Akimova E.B.
Subjects and methods. A total of 226 newborn infants with cerebral ischemia were examined. A control group consisted of 50 apparently healthy neonates.
Results. Progressive pathophysiological disorders in the conformation of hemoglobin and its ability to bind and release oxygen were ascertained to develop in the red blood cells of the newborn infants who had experienced perinatal hypoxia. Such impairments correlated with the severity of cerebral ischemia. Gassing with oxygen decreased the ability of hemoglobin to bind ligands and deteriorated its affinity for the latter.
Conclusion. The findings permit the use of Raman spectroscopic data to assess the severity of prior hypoxia and the correction of oxygenation parameters in newborns with cerebral ischemia.
Keywords
hypoxia
preeclampsia
cerebral ischemia
hemoglobin
Raman spectroscopy
Supplementary Materials
- Table 1. Characteristics of the newborn
- Figure 1. Changing the relationship of the intensities of the spectral bands of Raman scattering of hemoglobin in neonatal ischemic and hypoxic lesions of the CNS.
- Figure 2. The distribution of hemoglobin in the erythrocytes of newborns with cerebral ischemia: a - healthy newborn; b – newborn with a cerebral ischemia I, II (c), III degree (d).
- Figure 3. Changing the relationship of the intensities of the characteristic spectral bands of Raman scattering of hemoglobin in newborns with oxygen in vitro.
References
1. Zanelli S.A., Stanley D.P., Kaufman D. Hypoxic-ischemic encephalopathy. 2012. Available at: http://emedicine.medscape.com/article/973501
2. Volodin N.N., Mukhina Yu.G. Childhood diseases. Vol. 1. Neonatology. Moscow: Dynasty; 2011. 511p. (in Russian)
3. Mwaniki M.K., Atieno M., Lawn J.E., Newton C.R. Long-term neurodevelopmental outcomes after intrauterine and neonatal insults: a systematic review. Lancet. 2012; 379(9814): 445-52.
4. Shi J., Xiong Y., Mu D.Z. Clinical evidence for the pharmacological therapy in newborn infants with hypoxic-ischemic encephalopathy. Zhongguo Dang Dai Er Ke Za Zhi. 2009; 11(9): 740-4.
5. Huang Z.H., Sun Y., Chen C. Progress in encephalopathy of prematurity. Zhongguo Dang Dai Er Ke Za Zhi. 2011; 13(10): 771-5.
6. Distefano G., Praticò A.D. Actualities on molecular pathogenesis and repairing processes of cerebral damage in perinatal hypoxic-ischemic encephalopathy. Ital. J. Pediatr. 2010; 36: 63.
7. Takenouchi T., Cuaycong M., Ross G., Engel M., Perlman J.M. Chain of Brain Preservation-a concept to facilitate early identification and initiation of hypothermia to infants at high risk for brain injury. Resuscitation. 2010;81(12): 1637-41.
8. Edwards A.D., Brocklehurst P., Gunn A.J., Halliday H., Juszczak E., Levene M. et al. Neurological outcomes at 18 months of age after moderate hypothermia for perinatal hypoxic ischaemic encephalopathy: synthesis and meta-analysis of trial data. BMJ. 2010; 340: c363.
9. Higgins R.D., Raju T., Edwards A.D., Azzopardi D.V., Bose C.L., Clark R.H. et al. Hypothermia and other treatment options for neonatal encephalopathy: an executive summary of the Eunice Kennedy Shriver NICHD workshop. J. Pediatr. 2011; 159(5): 851-8.
10. Alonso-Alconada D., Álvarez A., Álvarez-Granda L., Hilario E. Therapeutic potential of the endocannabinoid system in perinatal asphyxia. Rev. Neurol. 2011; 53(12): 758-64.
11. Wood B.R., Caspers P., Puppels G.J., Pandiancherri S., McNaughton D. Resonance Raman spectroscopy of red blood cells using near-infrared laser excitation. Anal. Bioanal. Chem. 2007; 387(5): 1691-703.
Received 18.05.2016
Accepted 27.05.2016
About the Authors
Marusov Alexander Pavlovich, MD, Professor, Department of obstetrics and gynecology, N.P. Ogarev Mordovia State Medical University.430032, Russia, Saransk, Ulyanova str. 26A. E-mail: inst-med@adm.mrsu.ru
Ledyaykina Lyudmila Viktorovna, MD, Professor of Pediatrics, Deputy chief physician of Pediatrics, chief freelance neonatologist of the Republic of Mordovia, Mordovian Clinical Perinatal Center. 430013, Russia, Saransk, Pobedy str. 18. E-mail: ledlv@list.ru
Balykova Larisa Aleksandrovna, MD, Professor, Director of N.P. Ogarev Mordovia State Medical University.
430032, Russia, Saransk, Ulyanova str. 26A. E-mail: inst-med@adm.mrsu.ru
Gerasimenko Alexey Valentinovich, MD, Professor, honored doctor of the Republic of Mordovia, Director of Mordovian Clinical Perinatal Center.
430013, Russia, Saransk, Pobedy str. 18. E-mail: perinatrm@mail.ru
Akimova Ekaterina Borisovna, doctor-Intern, Department of Pediatrics, N.P. Ogarev Mordovia State Medical University.
430032, Russia, Saransk, Ulyanova str. 26A. Tel.: +79375132883. E-mail: blackmoon220@mail.ru
For citations: Marusov A.P., Ledyaikina L.V., Balykova L.A., Gerasimenko A.V., Akimova E.B. Impaired structural and functional properties of hemoglobin in the pathogenesis of fetal and neonatal hypoxia. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (1): 54-8. (in Russian)
http://dx.doi.org/10.18565/aig.2017.1.54-8
Similar Articles
