Detection of intravascular hemolysis in newborns using urinary carbonic anhydrase I immunoreactivity
<p><strong>Background:</strong><br /> Mild hemolysis occurs physiologically in neonates, but more severe forms can lead to life-threatening anemia. Newborns in developing regions are particularly at-risk due to the higher incidence of triggers (protozoan infections, sepsis, c...
| Prif Awduron: | , , , |
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| Fformat: | Journal article |
| Iaith: | English |
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Oxford University Press
2020
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| _version_ | 1826277060567367680 |
|---|---|
| author | Kramer, H Hulikova, A Khan, H Swietach, P |
| author_facet | Kramer, H Hulikova, A Khan, H Swietach, P |
| author_sort | Kramer, H |
| collection | OXFORD |
| description | <p><strong>Background:</strong><br />
Mild hemolysis occurs physiologically in neonates, but more severe forms can lead to life-threatening anemia. Newborns in developing regions are particularly at-risk due to the higher incidence of triggers (protozoan infections, sepsis, certain genetic traits). In advanced healthcare facilities, hemolysis is monitored indirectly using resource-intensive methods that probe downstream ramifications. These approaches could potentially delay critical decisions in early-life care, and are not suitable for point-of-care testing. Rapid and cost-effective testing could be based on detecting red blood cell (RBC)-specific proteins, such as carbonic anhydrase I (CAI), in accessible fluids (e.g., urine).</p><br />
<p><strong>Methods:</strong><br />
Urine was collected from 26 full-term male neonates and analyzed for CAI using immunoassays (ELISA, western blot) and proteomics (mass spectrometry). The cohort included a range of hemolytic states, including admissions with infection, ABO incompatibility, and receiving phototherapy. Data were paired with hemoglobin, serum bilirubin (SBR), and C-reactive protein (CRP) measurements.</p><br />
<p><strong>Results:</strong><br />
Urine from a control cohort (CRP < 20 mg/L, SBR < 125µmol/L) had no detectable CAI, in line with results from healthy adults. CAI excretion was elevated in neonates with raised SBR (>125 µmol/L), including those qualifying for phototherapy. Newborns with low SBR (<125 µmol/L) but elevated CRP (>20 mg/L) produced urine with strong CAI immunoreactivity. Proteomics showed that CAI was the most abundant RBC-specific protein in CAI-immunopositive samples, and did not associate with other RBC-derived peptides, indicating an intravascular hemolytic source followed by CAI-selective excretion.</p><br />
<p><strong>Conclusions:</strong><br />
CAI is a direct biomarker of intravascular hemolysis that can be measured routinely in urine using non-invasive methods under minimal-laboratory conditions.</p> |
| first_indexed | 2024-03-06T23:23:13Z |
| format | Journal article |
| id | oxford-uuid:697de2e3-816b-42af-b332-1fedb509cd6d |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T23:23:13Z |
| publishDate | 2020 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:697de2e3-816b-42af-b332-1fedb509cd6d2022-03-26T18:51:23ZDetection of intravascular hemolysis in newborns using urinary carbonic anhydrase I immunoreactivityJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:697de2e3-816b-42af-b332-1fedb509cd6dEnglishSymplectic ElementsOxford University Press2020Kramer, HHulikova, AKhan, HSwietach, P<p><strong>Background:</strong><br /> Mild hemolysis occurs physiologically in neonates, but more severe forms can lead to life-threatening anemia. Newborns in developing regions are particularly at-risk due to the higher incidence of triggers (protozoan infections, sepsis, certain genetic traits). In advanced healthcare facilities, hemolysis is monitored indirectly using resource-intensive methods that probe downstream ramifications. These approaches could potentially delay critical decisions in early-life care, and are not suitable for point-of-care testing. Rapid and cost-effective testing could be based on detecting red blood cell (RBC)-specific proteins, such as carbonic anhydrase I (CAI), in accessible fluids (e.g., urine).</p><br /> <p><strong>Methods:</strong><br /> Urine was collected from 26 full-term male neonates and analyzed for CAI using immunoassays (ELISA, western blot) and proteomics (mass spectrometry). The cohort included a range of hemolytic states, including admissions with infection, ABO incompatibility, and receiving phototherapy. Data were paired with hemoglobin, serum bilirubin (SBR), and C-reactive protein (CRP) measurements.</p><br /> <p><strong>Results:</strong><br /> Urine from a control cohort (CRP < 20 mg/L, SBR < 125µmol/L) had no detectable CAI, in line with results from healthy adults. CAI excretion was elevated in neonates with raised SBR (>125 µmol/L), including those qualifying for phototherapy. Newborns with low SBR (<125 µmol/L) but elevated CRP (>20 mg/L) produced urine with strong CAI immunoreactivity. Proteomics showed that CAI was the most abundant RBC-specific protein in CAI-immunopositive samples, and did not associate with other RBC-derived peptides, indicating an intravascular hemolytic source followed by CAI-selective excretion.</p><br /> <p><strong>Conclusions:</strong><br /> CAI is a direct biomarker of intravascular hemolysis that can be measured routinely in urine using non-invasive methods under minimal-laboratory conditions.</p> |
| spellingShingle | Kramer, H Hulikova, A Khan, H Swietach, P Detection of intravascular hemolysis in newborns using urinary carbonic anhydrase I immunoreactivity |
| title | Detection of intravascular hemolysis in newborns using urinary carbonic anhydrase I immunoreactivity |
| title_full | Detection of intravascular hemolysis in newborns using urinary carbonic anhydrase I immunoreactivity |
| title_fullStr | Detection of intravascular hemolysis in newborns using urinary carbonic anhydrase I immunoreactivity |
| title_full_unstemmed | Detection of intravascular hemolysis in newborns using urinary carbonic anhydrase I immunoreactivity |
| title_short | Detection of intravascular hemolysis in newborns using urinary carbonic anhydrase I immunoreactivity |
| title_sort | detection of intravascular hemolysis in newborns using urinary carbonic anhydrase i immunoreactivity |
| work_keys_str_mv | AT kramerh detectionofintravascularhemolysisinnewbornsusingurinarycarbonicanhydraseiimmunoreactivity AT hulikovaa detectionofintravascularhemolysisinnewbornsusingurinarycarbonicanhydraseiimmunoreactivity AT khanh detectionofintravascularhemolysisinnewbornsusingurinarycarbonicanhydraseiimmunoreactivity AT swietachp detectionofintravascularhemolysisinnewbornsusingurinarycarbonicanhydraseiimmunoreactivity |