Meral YÜKSEL, Özlem GÜNGÖR, Seyda İĞNAK TARLIĞ, Özlem UNAY DEMİREL

Paraoxonase-1 and fetuin-A levels in children with cerebral palsy

Background/aim: Studies mostly focused on risk factors and clinical status in children with cerebral palsy (CP). Various antiinflammatory markers may help us in the early diagnosis and clinical classification of cerebral palsy patients. In this study, the relationship between antiinflammatory marker levels and clinical status in patients with CP is determined. It is the first time that Fetuin-A and Paraoxonase-1 (PON-1) are examined in children with CP. Materials and methods: The study is conducted on 79 children which are divided into two groups as CP and control. Gross motor function and spasticity are evaluated in addition to biochemical parameters. Results: There is a statistically significant difference between CP and control group in terms of PON-1 activity, high sensitive C-Reactive Protein, HDL, and total cholesterol levels. There is no statistically significant difference in Fetuin A levels between the two groups. Conclusion: In suspected CP patients less than 24 months of age who possess prenatal and postnatal risk factors, the determination of PON-1 activity can be considered as a biomarker to support early diagnosis.

PDF

___

1. Mutch L, Alberman E, Hagberg B, Kodama K, Perat MV. Cerebral palsy epidemiology: where are we now and where are we going? Developmental Medicine and Child Neurology 1992; 34(6): 547-51. doi: 10.1111/j.1469-8749.1992.tb11479.x
2. Aycicek A, Iscan A. Oxidative and antioxidative capacity in children with cerebral palsy. Brain Research Bulletin 2006; 69 (6): 666-668. doi: 10.1016/j.brainresbull.2006.03.014
3. Marret S, Vanhulle C, Laquerriere A. Pathophysiology of cerebral palsy. Handbook of Clinical Neurology 2013; 111: 169-76. doi: 10.1016/B978-0-444-52891-9.00016-6
4. Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Surveillance of Cerebral Palsy in Europe (SCPE). Developmental Medicine and Child Neurology 2000; 42 (12): 816-824. doi: 10.1017/s0012162200001511
5. Tosun A, Gökben S, Serdaroğlu G, Polat M, Tekgül H. Changing views of cerebral palsy over 35 years: the experience of a center. The Turkish Journal of Pediatrics 2013; 55 (1): 8-15.
6. Sankar C, Mundkur N. Cerebral palsy-definition, classification, etiology and early diagnosis. Indian Journal of Pediatrics 2005; 72 (10): 865-868. doi: 10.1007/BF02731117
7. Camps J, Marsillach J, Joven J. The paraoxonases: role in human diseases and methodological difficulties in measurement. Critical Reviews in Clinical Laboratory Sciences 2009; 46 (2): 83-106. doi: 10.1080/10408360802610878
8. Menini T, Gugliucci A. Paraoxonase 1 in neurological disorders. Redox Report 2014; 19 (2): 49-58. doi:10.1179/135100021 3Y.0000000071
9. Heinen MC, Babler A, Weis J, Elsas J, Nolte K et al. Fetuin-A protein distribution in mature inflamed and ischemic brain tissue. PLoS One 2018; 13 (11): e0206597. doi: 10.1371/journal. pone.0206597
10. Elsas J, Sellhaus B, Herrmann M, Kinkeldey A, Weis J et al. Fetuin-A in the developing brain. Developmental Neurobiology 2013; 73 (5): 354-369. doi: 10.1002/dneu.22064.
11. Robinson KN, Teran-Garcia M. From infancy to aging: Biological and behavioral modifiers of Fetuin-A. Biochimie 2016; 124: 141-149. doi: 10.1016/j.biochi.2015.12.016
12. Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Developmental Medicine and Child Neurology 1997; 39 (4): 214–223. doi: 10.1111/j.1469-8749.1997.tb07414.x
13. Gregson JM, Leathley MJ, Moore AP, Smith TL, Sharma AK et al. Reliability of measurements of muscle tone and muscle power in stroke patients. Age Ageing 2000; 29 (3): 223-228. doi: 10.1093/ageing/29.3.223
14. Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Physical Therapy 1987; 67 (2): 206-207. doi: 10.1093/ptj/67.2.206
15. Russell DJ, Avery LM, Rosenbaum PL, Raina PS, Walter SD et al. Improved scaling of the gross motor function measure for children with cerebral palsy: evidence of reliability and validity. Physical Therapy 2000; 80(9): 873-885.
16. Yavuz DG, Yuksel M, Deyneli O, Ozen Y, Aydın H, Akalin S. Association of serum paraoxonase activity with insulin sensitivity and oxidative stress in hyperthyroid and TSHsuppressed nodular goitre patients. Clinical Endocrinology 2004; 61 (4): 515-521. doi: 10.1111/j.1365-2265.2004.02123.x
17. Baysal SS, Koc S. Oxidant-Antioxidant balance in patients with coronary slow flow. Journal of Pakistan Medical Association 2019; 35 (3): 786-792. doi: 10.12669/pjms.35.3.162
18. Mackness B, Durrington P, McElduff P, Yarnell J, Azam N et al. Low paraoxonase activity predicts coronary events in the Caerphilly Prospective Study. Circulation 2003; 107 (22): 2775- 7279. doi: 10.1161/01.CIR.0000070954.00271.13
19. Chen J, Kumar M, Chan W, Berkowitz G, Wetmur JG. Increased influence of genetic variation on PON1 activity in neonates. Environmental Health Perspectives 2003; 111 (11): 1403-1409. doi: 10.1289/ehp.6105
20. Roest M, Rodenburg J, Wiegman A, Kastelein JJ, Voorbij HA. Paraoxonase genotype and carotid intima-media thickness in children with familial hypercholesterolemia. European Journal of Cardiovascular Prevention & Rehabilitation 2006; 13 (3): 464-466. doi: 10.1097/00149831-200606000-00025
21. Ecobichon DJ, Stephens DS. Perinatal development of human blood esterases. Clinical Pharmacology & Therapeutics 1973; 14 (1): 41-47. doi: 10.1002/cpt197314141
22. Garcés C, López-Simón L, Rubio R, Benavente M, Cano B et al. High-density lipoprotein cholesterol and paraoxonase 1 (PON1) genetics and serum PON1 activity in prepubertal children in Spain. Clinical Chemistry and Laboratory Medicine 2008; 46 (6): 809-813. doi: 10.1515/CCLM.2008.163
23. Sumegová K, Nagyová Z, Waczulíková I, Zitnanová I, Duracková Z. Activity of paraoxonase 1 and lipid profile in healthy children. Physiological Research 2007; 56 (3): 351-357.
24. Huen K, Harley K, Brooks J, Hubbard A, Bradman A et al. Developmental changes in PON1 enzyme activity in young children and effects of PON1 polymorphisms. Environmental Health Perspectives 2009; 117 (10): 1632-1638. doi: 10.1289/ ehp.0900870
25. Yoon BH, Romero R, Shim JY, Shim SS, Kim CJ et al. C-reactive protein in umbilical cord blood: a simple and widely available clinical method to assess the risk of amniotic fluid infection and funisitis. Journal of Maternal-Fetal and Neonatal Medicine 2003; 14 (2): 85-90. doi: 10.1080/jmf.14.2.85.90
26. Ziakas A, Gavrilidis S, Giannoglou G, Souliou E, Gemitzis K et al. In-hospital and long-term prognostic value of fibrinogen, CRP, and IL-6 levels in patients with acute myocardial infarction treated with thrombolysis. Angiology 2006; 57 (3): 2832-93. doi: 10.1177/000331970605700304
27. Di Napoli M. C reactive protein and acute phase of ischaemic stroke. British Medical Journal 2001; 322(7302): 1605-1606.
28. Pingel J, Barber L, Andersen IT, Walden FV, Wong C et al. Systemic inflammatory markers in individuals with cerebral palsy. European Journal of Inflammation 2019, 17: 1-6. doi: 10.1177/2058739218823474
29. Michael-Asalu A, Taylor G, Campbell H, Lelea LL, Kirby RS. Cerebral Palsy: Diagnosis, Epidemiology, Genetics, and Clinical Update. Advances in Pediatrics 2019; 66: 189-208. doi: 10.1016/j.yapd.2019.04.002
30. Kinugasa-Taniguchi Y, Tomimatsu T, Mimura K, Kanagawa T, Shimoya K et al. Human C-reactive protein enhances vulnerability of immature rats to hypoxic-ischemic brain damage: a preliminary study. Reproductive Sciences 2010; 17 (5): 419-425. doi: 10.1177/1933719110361379
31. Schoendorfer NC, Vitetta L, Sharp N, DiGeronimo M, Wilson G et al. Micronutrient, antioxidant, and oxidative stress status in children with severe cerebral palsy. Journal of Parenteral and Enteral Nutrition 2013; 37 (1): 97-101. doi: 10.1177/0148607112447200
32. Cece H, Yetisgin A, Abuhandan M, Yildiz S, Calik M et al. Evaluation of carotid intima-media thickness, a marker of subclinical atherosclerosis, in children with cerebral palsy. Pediatric Radiology 2012; 42 (6): 6796-84. doi: 10.1007/ s00247-012-2361-y
33. McPhee PG, Gorter JW, Cotie LM, Timmons BW, Bentley T et al. Associations of non-invasive measures of arterial structure and function, and traditional indicators of cardiovascular risk in adults with cerebral palsy. Atherosclerosis 2015; 243 (2): 462- 465. doi: 10.1016/j.atherosclerosis.2015.09.035
34. Graham HK, Rosenbaum P, Paneth N, Dan B, Lin JP et al. Cerebral palsy. Nature Reviews Disease Primers 2016; 2: 15082. doi: 10.1038/nrdp.2015.82
35. Noble JJ, Gough M, Shortland AP. Selective motor control and gross motor function in bilateral spastic cerebral palsy. Developmental Medicine and Child Neurology 2019; 61 (1): 57-61. doi: 10.1111/dmcn.14024