Fleiss Bobbi, Tann Cally J, Degos Vincent, Sigaut Stéphanie, Van Steenwinckel Juliette, Schang Anne-Laure, Kichev Anton, Robertson Nicola J, Mallard Carina, Hagberg Henrik, Gressens Pierre
Inserm, U1141, Paris, France; University Paris Diderot, Sorbonne Paris Cité, UMRS 1141, Paris, France; Department of Child Neurology, APHP, Robert Debré Hospital, Paris, France; PremUP, Paris, France; Division of Imaging Sciences, Department of Perinatal Imaging and Health, King's College London, King's Health Partners, St. Thomas' Hospital, London, UK.
Dev Med Child Neurol. 2015 Apr;57 Suppl 3:17-28. doi: 10.1111/dmcn.12723.
Perinatal insults are a leading cause of infant mortality and amongst survivors are frequently associated with neurocognitive impairment, cerebral palsy (CP), and seizure disorders. The events leading to perinatal brain injury are multifactorial. This review describes how one subinjurious factor affecting the brain sensitizes it to a second injurious factor, causing an exacerbated injurious cascade. We will review the clinical and experimental evidence, including observations of high rates of maternal and fetal infections in term-born infants with neonatal encephalopathy and cerebral palsy. In addition, we will discuss preclinical evidence for the sensitizing effects of inflammation on injuries, such as hypoxia-ischaemia, our current understanding of the mechanisms underpinning the sensitization process, and the possibility for neuroprotection.
围产期损伤是婴儿死亡的主要原因，在幸存者中常与神经认知障碍、脑瘫（CP）和癫痫症相关。导致围产期脑损伤的事件是多因素的。本综述描述了一个影响大脑的亚损伤因素如何使其对第二个损伤因素敏感，从而导致加剧的损伤级联反应。我们将回顾临床和实验证据，包括对患有新生儿脑病和脑瘫的足月儿中母婴感染率高的观察。此外，我们将讨论炎症对诸如缺氧缺血等损伤的致敏作用的临床前证据、我们目前对致敏过程基础机制的理解以及神经保护的可能性。
