Diagnostic and Therapeutic Roles of the "Omics" in Hypoxic-Ischemic Encephalopathy in Neonates

Abstract

Perinatal asphyxia and neonatal encephalopathy remain major causes of neonatal mortality, despite the improved availability of diagnostic and therapeutic tools, contributing to neurological and intellectual disabilities worldwide. An approach using a combination of clinical data, neuroimaging, and biochemical parameters is the current strategy towards the improved diagnosis and prognosis of the outcome in neonatal hypoxic-ischemic encephalopathy (HIE) using bioengineering methods. Traditional biomarkers are of little use in this multifactorial and variable phenotype-presenting clinical condition. Novel systems of biology-based "omics" approaches (genomics, transcriptome proteomics, and metabolomics) may help to identify biomarkers associated with brain and other tissue injuries, predicting the disease severity in HIE. Biomarker studies using omics technologies will likely be a key feature of future neuroprotective treatment methods and will help to assess the successful treatment and long-term efficacy of the intervention. This article reviews the roles of different omics as biomarkers of HIE and outlines the existing knowledge of our current understanding of the clinical use of different omics molecules as novel neonatal brain injury biomarkers, which may lead to improved interventions related to the diagnostic and therapeutic aspects of HIE.

Keywords: biomarkers; genomics; hypoxic–ischemic encephalopathy; metabolomics; omics; proteomics.

Figure 1

The three phases of development of the pathophysiology of hypoxic–ischemic encephalopathy (HIE).

Figure 2

Principles of omics in clinical practice.

Figure 3

Proteomics markers in neonatal HIE.

Figure 4

Summary of omics in HIE. (A) The biomarkers found in a variety of body fluids, indicating the severity and presence of HIE. (B) Biomarkers of HIE as per their biochemistry.