Dixon Brandon J, Reis Cesar, Ho Wing Mann, Tang Jiping, Zhang John H
Department of Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, CA 92354, USA.
Department of Anesthesiology, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.
Int J Mol Sci. 2015 Sep 15;16(9):22368-401. doi: 10.3390/ijms160922368.
Neonatal hypoxic ischemic encephalopathy (HIE) is a devastating disease that primarily causes neuronal and white matter injury and is among the leading cause of death among infants. Currently there are no well-established treatments; thus, it is important to understand the pathophysiology of the disease and elucidate complications that are creating a gap between basic science and clinical translation. In the development of neuroprotective strategies and translation of experimental results in HIE, there are many limitations and challenges to master based on an appropriate study design, drug delivery properties, dosage, and use in neonates. We will identify understudied targets after HIE, as well as neuroprotective molecules that bring hope to future treatments such as melatonin, topiramate, xenon, interferon-beta, stem cell transplantation. This review will also discuss some of the most recent trials being conducted in the clinical setting and evaluate what directions are needed in the future.
新生儿缺氧缺血性脑病(HIE)是一种严重的疾病,主要导致神经元和白质损伤,是婴儿死亡的主要原因之一。目前尚无成熟的治疗方法;因此,了解该疾病的病理生理学并阐明导致基础科学与临床转化之间存在差距的并发症非常重要。在HIE神经保护策略的开发和实验结果的转化过程中,基于适当的研究设计、药物递送特性、剂量以及在新生儿中的应用,有许多限制和挑战需要掌握。我们将确定HIE后研究不足的靶点,以及为未来治疗带来希望的神经保护分子,如褪黑素、托吡酯、氙气、β干扰素、干细胞移植。本综述还将讨论一些正在临床环境中进行的最新试验,并评估未来需要哪些方向。