Biomarkers of brain injury in foals with neonatal maladjustment syndrome.

BACKGROUND: Plasma concentrations of brain-derived neurotrophic factor (BDNF), glial-fibrillary-acidic protein (GFAP), and astrocytic protein S100B, might be linked to the pathophysiology of Neonatal Maladjustment Syndrome (NMS). HYPOTHESIS/OBJECTIVES: To measure serum concentration of BDNF and S100B, plasma concentration of GFAP, and neurosteroids (progesterone and 17α-hydroxyprogesterone) in foals with NMS, foals presented for other diseases, including premature, and healthy foals, and determine their association with outcome. ANIMALS: Fourteen healthy foals, 19 NMS foals, 39 foals hospitalized for other diseases < 7 days of age. METHODS: In this prospective, longitudinal study, concentrations of biomarkers were determined in all foals on admission, at day 1 and 2 of hospitalization. Plasma or serum concentration of biomarkers was measured with ELISA and single-molecule-array technology. RESULTS: Forty-eight foals survived, 10 did not survive. Serum BDNF concentration was lower after 24 h of hospitalization in NMS foals (baseline: 3.0, 1.9-4.1 g/mL; day 1: 2.0, 1.2-2.8 pg/mL) (P = .02). Serum S100B was higher in septic foals with NMS (marginal means, 95% CI, 435.3, 290-580 ng/mL) compared to septic foals without NMS (238.9, 164.6-313.2 ng/mL) on admission (P = .01). Pregnane concentrations were higher in NMS foals compared to healthy and sick foals over the first 48 h of hospitalization (P < .05). CONCLUSIONS AND CLINICAL IMPORTANCE: Higher BDNF, S100B, and pregnane concentrations were consistent with NMS, and might allow for neurological assessment.