Neonatal Intensive Care Unit, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, INSERM, Paris, France; PremUP Foundation, Paris, France.
Dev Med Child Neurol. 2014 Aug;56(8):717-23. doi: 10.1111/dmcn.12415. Epub 2014 Feb 27.
The prevention of neurological disabilities following preterm birth remains a major public health challenge and efforts are still needed to test the neuroprotective properties of candidate molecules. Melatonin serves as a neuroprotectant in adult models of cerebral ischemia through its potent antioxidant and anti-inflammatory effects. An increasing number of preclinical studies have consistently demonstrated that melatonin protects the damaged developing brain by preventing abnormal myelination and an inflammatory glial reaction, a major cause of white matter injury. The main questions asked in this review are whether preclinical data on the neuroprotective properties of melatonin are sufficient to translate this concept into the clinical setting, and whether melatonin can reduce white matter damage in preterm infants. This review provides support for our view that melatonin is now ready to be tested in human preterm neonates, and discusses ongoing and planned clinical trials.
预防早产儿神经功能障碍仍然是一个主要的公共卫生挑战，仍需要努力测试候选分子的神经保护特性。褪黑素通过其强大的抗氧化和抗炎作用，在成人脑缺血模型中作为神经保护剂。越来越多的临床前研究一致表明，褪黑素通过防止异常髓鞘形成和炎症性神经胶质反应来保护受损的发育中大脑，这是白质损伤的主要原因。本篇综述中提出的主要问题是，关于褪黑素的神经保护特性的临床前数据是否足以将这一概念转化为临床环境，以及褪黑素是否可以减少早产儿的白质损伤。这篇综述支持我们的观点，即褪黑素现在已经准备好在人类早产儿中进行测试，并讨论了正在进行和计划中的临床试验。
