Lessons learned from proteome analysis of perinatal neurovascular pathologies

ABSTRACT

Introduction

Perinatal and pediatric diseases related to neurovascular disorders cause significant problems during life, affecting a population with a long life expectancy. Early diagnosis and assessment of the severity of these diseases are crucial to establish an appropriate neuroprotective treatment. Currently, physical examination, neuroimaging and clinical judgment are the main tools for diagnosis, although these tests have certain limitations. There is growing interest in the potential value of noninvasive biomarkers that can be used to monitor child patients at risk of brain damage, allowing accurate, and reproducible measurements.

Areas covered

This review describes potential biomarkers for the diagnosis of perinatal neurovascular diseases and discusses the possibilities they open for the classification and treatment of neonatal neurovascular diseases.

Expert opinion

Although high rates of ischemic and hemorrhagic stroke exist in pediatric populations, most studies have focused on biomarkers of hypoxic-ischemic encephalopathy. Inflammatory and neuronal biomarkers such as S-100B and GFAP, in combination with others yet to be discovered, could be considered as part of multiplex panels to diagnose these diseases and potentially for monitoring response to treatments. Ideally, noninvasive biofluids would be the best source for evaluating these biomarkers in proteomic assays in perinatal patients.

KEYWORDS:

• Pediatric
• perinatal
• neonatal
• brain ischemia
• biomarkers
• neurodevelopment
• proteomics

Article highlights

• The subtle signs and symptoms of neonatal HIEs and stroke require new diagnostic tests.

• Perinatal strokes are often misdiagnosed leaving scarce therapeutic options.

• Biomarkers screening opens a new window in the early diagnosis of perinatal and paediatric patients with neurovascular diseases.

• The biomarkers will offer a new way to monitor treatments.

• The easy detection of S-100 and its presence in numerous biofluids after neuronal damage, positions this molecule as an interesting biomarker to be complemented by new brain damage markers for neurovascular diseases.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This work was supported by grants from Fundación Alicia Koplowitz “Ayudas a proyectos de investigación” 2018 to J.M.; the Andalusian Health Service, Junta de Andalucia (Servicio Andalúz de Salúd, Junta de Andalucía; C-0025-2018 to P.Y.-G.); Instituto de Salud Carlos III (contrato Río Hortega 2018; CM18/00106 to PMV). The Neurovascular Research Lab at IBIS is part of the Spanish StrokeResearch Network (INVICTUS+; RD16/0019/0015).