Time-resolved urinary proteomics reveals heme-associated oxidative stress responses in neonatal hypoxic-ischaemic encephalopathy

We identified transient and sustained proteomic shifts that trace coordinated changes in oxidative stress, heme metabolism, and metabolic adaptation, alongside key regulators such as IL1A, TNF, EHF, PPARD, and TXNIP. The progression from early injury-related divergence to partial recovery by day 8 highlights the dynamic nature of post-insult remodeling. These findings support urinary proteomics as a robust, non-invasive tool for probing HIE pathophysiology and point to promising biomarker and pathway candidates for future studies.