Effect of selective head cooling on serum pyroptosis-related molecules in neonates with hypoxic-ischemic encephalopathy

ObjectiveTo investigate the effects of selective head cooling(SHC) on the serum levels of key proteins and cytokines related to pyroptosisincluding cysteinyl aspartate specific proteinase-1(Caspase-1), interleukin(IL)-1β and IL-18 in neonates with hypoxic-ischemic encephalopathy(HIE) in order to understand the possible neuroprotective mechanism of SHC in the treatment of HIE.

MethodsA total of 45 neonates with HIE and 10 normal neonates during the same period were divided into the HIE group and control group, respectively.The HIE group was subdivided into the mild HIE group(13 cases), moderate HIE group(20 cases) and severe HIE group(12 cases) according to clinical staging.According to the cooling therapy criteria, 32 cases moderate and severe HIE neonates were divided into the conventional treatment group(15 cases) and SHC group(17 cases).The serum levels of Caspase-1, IL-1β and IL-18 in all groups were detected using ELISA, and compared.

ResultsThe serum levels of Caspase-1 and IL-1β in mild, moderate and severe HIE groups were higher than those in control group, and the levels of Caspase-1 and IL-1β increased with the aggravating of clinical staging of HIE(P < 0.05).The serum levels of IL-18 in moderate and severe HIE groups were higher than that in mild HIE group and control group(P < 0.05).The serum levels of Caspase-1, IL-1β and IL-18 in neonates with HIE were significantly positively correlated with the clinical staging of HIE(r_s=0.820, 0.913 and 0.683, P < 0.01).There was no statistical significance in the serum levels of Caspase-1, IL-1β and IL-18 between SHC group and conventional treatment group before treatment(P>0.05).The serum level of Caspase-1 at 24 h and levels of Caspase-1, IL-1β and IL-18 at 48 h and 72 h of treatment in SHC group were significantly lower than those in conventional treatment group(P < 0.01).at 48 h and 72 h of treatment, the levels of Caspase-1, IL-1β and IL-18 in SHC group were lower than those at 0 h and 24 h(P < 0.05).The serum levels of Caspase-1, IL-1β and IL-18 in conventional treatment group at 48 h of treatment increased compared with at 0 h(P < 0.05), the levels of IL-1β and IL-18 at 72 h were still higher than that at 0 h(P < 0.05), while there was no statistical significance in the level of Caspase-1 between 72 h and 0 h(P>0.05).

ConclusionsThe selective head cooling in the treatment of HIE can achieve neuroprotection by reducing the level of pyroptosis.