Elitt C M, Rosenberg P A
Department of Neurology and the F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA 02115, USA; Program in Neuroscience, Harvard Medical School, Boston, MA 02115, USA.
Department of Neurology and the F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA 02115, USA; Program in Neuroscience, Harvard Medical School, Boston, MA 02115, USA.
Neuroscience. 2014 Sep 12;276:216-38. doi: 10.1016/j.neuroscience.2014.04.038. Epub 2014 May 15.
White matter injury in the premature infant leads to motor and more commonly behavioral and cognitive problems that are a tremendous burden to society. While there has been much progress in understanding unique vulnerabilities of developing oligodendrocytes over the past 30years, there remain no proven therapies for the premature infant beyond supportive care. The lack of translational progress may be partially explained by the challenge of developing relevant animal models when the etiology remains unclear, as is the case in this disorder. There has been an emphasis on hypoxia-ischemia and infection/inflammation as upstream etiologies, but less consideration of other contributory factors. This review highlights the evolution of white matter pathology in the premature infant, discusses the prevailing proposed etiologies, critically analyzes a sampling of common animal models and provides detailed support for our hypothesis that nutritional and hormonal deprivation may be additional factors playing critical and overlooked roles in white matter pathology in the premature infant.
早产儿的白质损伤会导致运动问题导致运动问题，更常见的是行为和认知问题，这给社会带来了巨大负担。虽然在过去30年里，在了解发育中的少突胶质细胞的独特脆弱性方面取得了很大进展，但除了支持性护理外，对于早产儿仍没有经过验证的治疗方法。当病因仍不清楚时，就像这种疾病的情况一样，缺乏转化研究进展可能部分是由于开发相关动物模型面临的挑战。一直以来都强调缺氧缺血和感染/炎症是上游病因，但对其他促成因素的考虑较少。这篇综述强调了早产儿白质病理学的演变，讨论了普遍提出的病因，批判性地分析了一些常见动物模型的样本，并为我们的假设提供了详细支持，即营养和激素缺乏可能是在早产儿白质病理学中起关键但被忽视作用的额外因素。
