Zalewska Teresa, Jaworska Joanna, Ziemka-Nalecz Malgorzata
NeuroRepair Department, Mossakowski Medical Research Centre, Polish Academy of Sciences, Pawinskiego Str., 5, 02-106 Warsaw, Poland.
Curr Pharm Des. 2015;21(11):1433-9. doi: 10.2174/1381612820999141029162457.
Neonatal hypoxic-ischemic (HI) injury still remains an important issue as it is a frequent cause of neonatal death and life-long neurobehavioral and cognitive dysfunction. In spite of the decades of research which led us to a better knowledge of the pathological mechanism of hypoxic-ischemic brain injury, the clinical use of potential neuroprotective drugs (including, among others, excitatory amino acids antagonists, free radical inhibitors and scavengers, growth factors, xenon, cannabinoids, anti-inflammatory and anti-apoptotic agents) became avoided owing to insufficiency and /or treatment-induced undesirable side effects. The only available effective treatment, hypothermia, neither provides complete brain protection nor stimulates the repair necessary for neurodevelopmental outcome. This fact brings about increased interest in alternative methods of therapy, such as regenerative medicine using stem cells. Growing number of in vivo preclinical studies revealed that mesenchymal stem cells as well as human cord blood cells may improve functional outcome after HI insult and may represent a new beneficial treatment modality for infants developing hypoxic-ischemic encephalopathy. In this review we briefly highlight the present and potential forthcoming therapeutic treatments aimed at attenuation of the detrimental effects of neonatal hypoxia-ischemia.
新生儿缺氧缺血性（HI）损伤仍然是一个重要问题，因为它是新生儿死亡以及终身神经行为和认知功能障碍的常见原因。尽管经过数十年的研究，我们对缺氧缺血性脑损伤的病理机制有了更深入的了解，但由于疗效不足和/或治疗引起的不良副作用，潜在神经保护药物（包括兴奋性氨基酸拮抗剂、自由基抑制剂和清除剂、生长因子、氙气、大麻素、抗炎和抗凋亡药物等）的临床应用却被避免了。唯一可用的有效治疗方法——低温疗法，既不能提供完全的脑保护，也不能刺激神经发育结果所需的修复。这一事实引发了人们对替代治疗方法的更多兴趣，比如使用干细胞的再生医学。越来越多的体内临床前研究表明，间充质干细胞以及人脐带血细胞可能改善HI损伤后的功能结果，并且可能代表了一种针对患缺氧缺血性脑病婴儿的新的有益治疗方式。在这篇综述中，我们简要强调了目前以及未来可能出现的旨在减轻新生儿缺氧缺血有害影响的治疗方法。
