Relationship between brain injury and changes of serum Tau and TLR4 levels in premature infants

doi:10.3877/cma.j.issn.2095-9141.2022.06.006

Abstract

Abstract:

Objective

To analyze the expression levels of microtubule-associated protein Tau and Toll-like receptor 4 (TLR4) in serum of preterm infants with brain injury (BIPI) and their relationship with the severity of brain injury.

Methods

A total of 70 BIPI born in Pediatrics Department of Panzhihua Integrated Traditional Chinese and Western Medicine Hospital from October 2018 to May 2020 were selected as the brain injury goup. According to clinical symptoms and examination results of head MRI, they were divided into mild brain white matter injury group (22 cases), moderate brain white matter injury group (27 cases) and severe brain white matter injury group (21 cases). Another 70 premature infants without brain injury born in the same period were selected as the non-brain injury group. The brain function of BIPI was monitored by amplitude integrated electroencephalogram (aEEG). On the 1^st, 3^rd and 7^th day after birth, levels of serum microtubule-associated protein (Tau) and Toll-like receptor 4 (TLR4) in each group were detected by enzyme-linked immunosorbent assay (ELISA). The predictive value of serum Tau and TLR4 levels in different periods for BIPI was compared. The value of serum Tau and TLR4 levels in predicting the occurrence of BIPI was analyzed by receiver operating characteristic (ROC) curve. The changes in levels of serum Tau and TLR4 among premature infants with different degrees of brain white matter injury were compared.

Results

There was no significant difference in gender ratio, gestational age or birth weight between non-brain injury group and brain injury group (P>0.05). The aEEG score of full-term corrected gestational age in brain injury group was significantly lower than that in non-brain injury group (P < 0.05). On the 1^st, 3^rd and 7^th day after birth, levels of serum Tau and TLR4 in brain injury group were significantly higher than those in non-brain injury group, and the level of serum Tau gradually decreased over time and the level of serum TLR4 increased first and then decreased. The AUC values predicted by BIPI by combined detection of serum Tau and TLR4 levels for preterm infants on the 1^st, 3^rd and 7^th day after birth are 0.639, 0.930 and 0.887, which was better than the single prediction. On the 1^st, 3^rd and 7^th day after birth, the level of serum Tau increased significantly with the severity of cerebral white matter injury and the level of serum TLR4 was the highest on the 3^rd day after birth, the difference was statistically significant (P<0.05).

Conclusion

The expression of Tau and TLR4 in serum is related to the degree of cerebral white matter injury in children, which can be used to evaluate the progression of BIPI.

Key words: Premature infant, Brain injury, Microtubule associated protein Tau, Toll-like receptor-4

Jie Luo, Jie Li. Relationship between brain injury and changes of serum Tau and TLR4 levels in premature infants[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2022, 08(06): 346-350.

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References 26

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组别	例数	性别（男/女）	胎龄（周，±s）	出生体质量（g，±s）	矫正胎龄足月时aEEG评分（分，±s）
无脑损伤组	70	40/30	31.71±0.82	1685.23±256.21	10.13±1.05
脑损伤组	70	42/28	31.62±0.71	1762.21±234.42	7.89±0.81
t/χ²值		0.118	0.694	1.854	14.132
P值		0.731	0.489	0.066	<0.001

组别	例数	性别（男/女）	胎龄（周，±s）	出生体质量（g，±s）	矫正胎龄足月时aEEG评分（分，±s）
无脑损伤组	70	40/30	31.71±0.82	1685.23±256.21	10.13±1.05
脑损伤组	70	42/28	31.62±0.71	1762.21±234.42	7.89±0.81
t/χ²值		0.118	0.694	1.854	14.132
P值		0.731	0.489	0.066	<0.001

组别	例数	Tau					TLR4
组别	例数	第1天	第3天	第7天	F值	P值	第1天	第3天	第7天	F值	P值
无脑损伤组	70	0.56±0.05	0.36±0.03^a	0.21±0.02^ab	81.880	<0.001	1.38±0.14	1.30±0.12^a	1.24±0.12^ab	79.300	<0.001
脑损伤组	70	0.61±0.06	0.56±0.06^a	0.48±0.05^ab	88.240	<0.001	1.58±0.15	3.01±0.31^a	1.46±0.15^ab	177.900	<0.001
t值		0.536	24.944	41.948			8.156	43.039	9.580
P值		<0.001	<0.001	<0.001			<0.001	<0.001	<0.001

组别	例数	Tau					TLR4
组别	例数	第1天	第3天	第7天	F值	P值	第1天	第3天	第7天	F值	P值
无脑损伤组	70	0.56±0.05	0.36±0.03^a	0.21±0.02^ab	81.880	<0.001	1.38±0.14	1.30±0.12^a	1.24±0.12^ab	79.300	<0.001
脑损伤组	70	0.61±0.06	0.56±0.06^a	0.48±0.05^ab	88.240	<0.001	1.58±0.15	3.01±0.31^a	1.46±0.15^ab	177.900	<0.001
t值		0.536	24.944	41.948			8.156	43.039	9.580
P值		<0.001	<0.001	<0.001			<0.001	<0.001	<0.001

指标	时间	AUC	95%CI	P值
Tau	第1天	0.626	0.540~0.706	0.008
	第3天	0.764	0.685~0.831	<0.001
	第7天	0.819	0.745~0.879	<0.001
TLR4	第1天	0.582	0.496~0.665	<0.036
	第3天	0.820	0.746~0.880	<0.001
	第7天	0.787	0.710~0.852	<0.001
联合预测	第1天	0.639	0.553~0.718	0.003
	第3天	0.930	0.874~0.966	<0.001
	第7天	0.887	0.822~0.934	<0.001

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