Neuroprotective Strategies for the Neonatal Brain

Inserm, U676, Paris, France.
Anesthesia and analgesia (Impact Factor: 3.47). 07/2008; 106(6):1670-80. DOI: 10.1213/ane.0b013e3181733f6f
Source: PubMed


Injury to the perinatal brain is a leading cause of childhood mortality and lifelong disability. Cerebral palsy and cognitive impairment are usually related to periventricular white matter damage, which is seen chiefly in babies born before 32 wk gestational age, and to corticosubcortical lesions, which occur mainly in full-term infants. Despite recent improvements in neonatal care, no effective treatment for perinatal brain lesions is available. Several interventions, such as magnesium sulfate in preterm newborns and hypothermia in term newborns, are the focus of completed or continuing clinical trials. Improved understanding of the pathophysiological mechanisms involved in perinatal brain lesions helps to identify potential targets for neuroprotective interventions, as discussed in this review.

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Available from: Pierre Gressens, Apr 18, 2014
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    • "Current treatment options for the vulnerable neonate are very limited and development of new therapies remains a major challenge to medical science. HI cerebral injury is characterized by damaged or dying neurons , glia, and endothelial cells (Degos et al., 2008; Ferriero, 2004). The brain develops a restorative adaptive response to this injury consisting of early anti-inflammatory and anti-apoptotic signaling (Yang et al., 2007; Bartley et al., 2005; Hedtjarn et al., 2004; Allan and Rothwell, 2001). "
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    • "This leads to oedema formation and infiltration of inflammatory cells such as macrophages and neutrophils into the brain, but also to relocation and proliferation of resident microglia at the injured site (Alvarez-Diaz et al., 2007; Bona et al., 1999; Degos et al., 2008; Hudome et al., 1997; McRae et al., 1995). The inflammatory cells can produce several pro‐inflammatory mediators that increase the inflammation further, as well as neurotrophic substances that promote neuronal survival (Alvarez-Diaz et al., 2007; Bona et al., 1999; Degos et al., 2008; Hedtjarn et al., 2004). "

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