Netto C A, Sanches E F, Odorcyk F, Duran-Carabali L E, Sizonenko S V
Biochemistry Department, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil.
Biochemistry Department, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, UFRGS, Porto Alegre, Brazil.
Int J Dev Neurosci. 2018 Nov;70:12-24. doi: 10.1016/j.ijdevneu.2018.06.004. Epub 2018 Jun 18.
Neonatal brain Hypoxia-Ischemia (HI) is one of the major causes of infant mortality and lifelong neurological disabilities. The knowledge about the physiopathological mechanisms involved in HI lesion have increased in recent years, however these findings have not been translated into clinical practice. Current therapeutic approaches remain limited; hypothermia, used only in term or near-term infants, is the golden standard. Epidemiological evidence shows a link between adverse prenatal conditions and increased risk for diseases, health problems, and psychological outcomes later in life, what makes pregnancy a relevant period for preventing future brain injury. Here, we review experimental literature regarding preventive interventions used during pregnancy, i.e., previous to the HI injury, encompassing pharmacological, nutritional and/or behavioral strategies. Literature review used PubMed database. A total of forty one studies reported protective properties of maternal treatments preventing perinatal hypoxia-ischemia injury in rodents. Pharmacological agents and dietary supplementation showed mainly anti-excitotoxicity, anti-oxidant or anti-apoptotic properties. Interestingly, maternal preconditioning, physical exercise and environmental enrichment seem to engage the same referred mechanisms in order to protect neonatal brain against injury. This construct must be challenged by further studies to clearly define the main mechanisms responsible for neuroprotection to be explored in experimental context, as well as to test their potential in clinical settings.
新生儿脑缺氧缺血（HI）是婴儿死亡和终身神经残疾的主要原因之一。近年来，关于HI损伤所涉及的生理病理机制的知识有所增加，然而这些发现尚未转化为临床实践。目前的治疗方法仍然有限；仅用于足月儿或近足月儿的低温疗法是金标准。流行病学证据表明，不良的产前状况与日后生活中疾病、健康问题和心理结果的风险增加之间存在联系，这使得孕期成为预防未来脑损伤的一个重要时期。在此，我们综述了关于孕期（即HI损伤之前）所采用的预防性干预措施的实验文献，包括药理学、营养和/或行为策略。文献综述使用了PubMed数据库。共有41项研究报告了母体治疗对预防啮齿动物围产期缺氧缺血性损伤的保护特性。药物制剂和膳食补充剂主要表现出抗兴奋毒性、抗氧化或抗凋亡特性。有趣的是，母体预处理、体育锻炼和环境富集似乎通过相同的相关机制来保护新生儿脑免受损伤。必须通过进一步的研究来验证这一构想，以便在实验环境中明确界定负责神经保护的主要机制，并在临床环境中测试其潜力。
