J Clin Neurol.  2017 Jan;13(1):84-90. 10.3988/jcn.2017.13.1.84.

Human Umbilical Cord Blood CD34-Positive Cells as Predictors of the Incidence and Short-Term Outcome of Neonatal Hypoxic-Ischemic Encephalopathy: A Pilot Study

• Hassanein
• Nasr Eldin MH
• Amer HA
• Abdelhamid AE
• El Houssinie M
• Ibrahim A

• KMID: 2364902
• DOI: http://doi.org/10.3988/jcn.2017.13.1.84

Abstract

BACKGROUND AND PURPOSE
Neonatal hypoxic-ischemic encephalopathy (HIE) is one of the leading causes of neurological handicap in developing countries. Human umbilical cord blood (hUCB) CD34-positive (CD34⁺) stem cells exhibit the potential for neural repair. We tested the hypothesis that hUCB CD34⁺ stem cells and other cell types [leukocytes and nucleated red blood cells (NRBCs)] that are up-regulated during the acute stage of perinatal asphyxia (PA) could play a role in the early prediction of the occurrence, severity, and mortality of HIE.
METHODS
This case-control pilot study investigated consecutive neonates exposed to PA. The hUCB CD34⁺ cell count in mononuclear layers was assayed using a flow cytometer. Twenty full-term neonates with PA and 25 healthy neonates were enrolled in the study.
RESULTS
The absolute CD34⁺ cell count (p=0.02) and the relative CD34⁺ cell count (CD34+%) (p<0.001) in hUCB were higher in the HIE patients (n=20) than the healthy controls. The hUCB absolute CD34⁺ cell count (p=0.04), CD34⁺% (p<0.01), and Hobel risk scores (p=0.04) were higher in patients with moderate-to-severe HIE (n=9) than in those with mild HIE (n=11). The absolute CD34⁺ cell count was strongly correlated with CD34⁺% (p<0.001), Hobel risk score (p=0.04), total leukocyte count (TLC) (p<0.001), and NRBC count (p=0.01). CD34+% was correlated with TLC (p=0.02).
CONCLUSIONS
hUCB CD34⁺ cells can be used to predict the occurrence, severity, and mortality of neonatal HIE after PA.

Keyword

full-term neonates; Hobel risk score; mononuclear layer; perinatal asphyxia; stem cells; Thompson score

MeSH Terms

Asphyxia
Case-Control Studies
Cell Count
Developing Countries
Erythrocytes
Fetal Blood*
Humans*
Hypoxia-Ischemia, Brain*
Incidence*
Infant, Newborn
Leukocyte Count
Mortality
Pilot Projects*
Stem Cells
Umbilical Cord*

Figure

• 

  Fig. 1 hUCB absolute CD34-positive (CD34+) cell count at birth in all of the studied neonates. hUCB: human umbilical cord blood.

• 

  Fig. 2 hUCB relative CD34+ cell count (CD34+%) at birth in all of the studied neonates. hUCB: human umbilical cord blood.

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