Marcheri biochimici de lezare a sistemului nervos central al fătului

Abstract

Background: In prenatal medicine for intrauterine assessment of fetal well being are used different instrumental investigations as Cardiotocography, Ultrasonography with Doppler and more sophisticated such as: Magnetic Resonance Imaging. Innovative aproach in perinatal medicine requires descovery of new neuromarkers with high sensibility to neuronal tissue, which can cross hematoencephalic and uteroplacentar barrier that can be used for early diagnostic of fetal cerebral tisue lesions and/or for monitorisation of pathologic process progression as well as for assessment of efficacy of medical treatment. A lot of scientific research demonstrated the diagnostic value of neuroproteins in biologic fluids with a predictive value of brain lesions. The most studied markers are: protein S100B, Activin A, Eritropoietin, Chemokins (C-C motif), Plasminogen activator inhibitor 1 (PAI-1), Glial fibrillary acidic protein (GFAP), Creatine kinase BB (CK-BB), Neurofilament L (NFL). Most promissing are Protein S100B and Activin A. Determination of fetal cerebral constituents, especially protein S100B, may be an alternative diagnostic method of neuronal lesion, when classic clinic and imagistic investigations are still sillent and therapeutic window is still open, having economic and diagnostic non negligible advantage. S100B protein satisfies all criteria of fetal cerebral lesion marker, motivated by high sensibility and specificity to cerebral tissue, simplicity in execution method, possibility of determination in different biologic fluids. Conclusion: Modern scientific concept proposes the use of biochemical neuromarkers as alternative to clasical instrumental investigations. Most studied and most informative are protein S100B and Activin A. Implimentation of brain lesion markers research may offer important information about fetal cerebral lesion, so, it may be useful in high risk pregnancy.