Hagberg Henrik, Mallard Carina, Ferriero Donna M, Vannucci Susan J, Levison Steven W, Vexler Zinaida S, Gressens Pierre
1] Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London SE1 7EH, UK. [2] Perinatal Center, Institute of Physiology and Neurosciences and Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 435 43 Gothenburg, Sweden.
Perinatal Center, Institute of Physiology and Neurosciences and Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 435 43 Gothenburg, Sweden.
Nat Rev Neurol. 2015 Apr;11(4):192-208. doi: 10.1038/nrneurol.2015.13. Epub 2015 Feb 17.
Inflammation is increasingly recognized as being a critical contributor to both normal development and injury outcome in the immature brain. The focus of this Review is to highlight important differences in innate and adaptive immunity in immature versus adult brain, which support the notion that the consequences of inflammation will be entirely different depending on context and stage of CNS development. Perinatal brain injury can result from neonatal encephalopathy and perinatal arterial ischaemic stroke, usually at term, but also in preterm infants. Inflammation occurs before, during and after brain injury at term, and modulates vulnerability to and development of brain injury. Preterm birth, on the other hand, is often a result of exposure to inflammation at a very early developmental phase, which affects the brain not only during fetal life, but also over a protracted period of postnatal life in a neonatal intensive care setting, influencing critical phases of myelination and cortical plasticity. Neuroinflammation during the perinatal period can increase the risk of neurological and neuropsychiatric disease throughout childhood and adulthood, and is, therefore, of concern to the broader group of physicians who care for these individuals.
炎症越来越被认为是未成熟大脑正常发育和损伤结果的关键因素。本综述的重点是强调未成熟大脑与成人大脑在先天免疫和适应性免疫方面的重要差异，这支持了这样一种观点，即炎症的后果将因中枢神经系统发育的背景和阶段而完全不同。围产期脑损伤可由新生儿脑病和围产期动脉缺血性中风引起，通常发生在足月时，但也可发生在早产儿中。足月时，炎症在脑损伤之前、期间和之后发生，并调节脑损伤的易感性和发展。另一方面，早产通常是在非常早期的发育阶段接触炎症的结果，这不仅在胎儿期影响大脑，而且在新生儿重症监护环境中的出生后很长一段时间内也会影响大脑，影响髓鞘形成和皮质可塑性的关键阶段。围产期的神经炎症会增加儿童期和成年期患神经和神经精神疾病的风险，因此，这受到照顾这些个体的更广泛医生群体的关注。
