Chang Jill L, Bashir Mirrah, Santiago Christiana, Farrow Kathryn, Fung Camille, Brown Ashley S, Dettman Robert W, Dizon Maria L V
Division of Neonatology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA,
Division of Neonatology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Dev Neurosci. 2018;40(4):344-357. doi: 10.1159/000494273. Epub 2018 Nov 14.
Intrauterine growth restriction (IUGR) is estimated to occur in 5% of pregnancies, with placental insufficiency being the most common cause in developed countries. While it is known that white matter injury occurs in premature infants, the extent of IUGR on white matter injury is less defined in term infants. We used a novel murine model that utilizes a thromboxane A2 (TXA2) analog (U46619), a potent vasoconstrictor, to induce maternal hypertension and mimic human placental insufficiency-induced IUGR to study the white matter. We also investigated the role of hyperoxia as an additional risk factor for white matter injury, as IUGR infants are at increased risk of respiratory comorbidities leading to increased oxygen exposure. We found that TXA2 analog-induced IUGR results in white matter injury as demonstrated by altered myelin structure and changes in the oligodendroglial cell/oligodendrocyte population. In addition, our study demonstrates that hyperoxia exposure independently results in white matter perturbation. To our knowledge, this is the first study to report single and combined effects of IUGR with hyperoxia impacting the white matter and motor function. These results draw attention to the need for close monitoring of motor development in IUGR babies following hospital discharge as well as highlighting the importance of limiting, as clinically feasible, the degree of oxygen overexposure to potentially improve motor outcomes in this population of infants.
据估计,5%的妊娠会发生宫内生长受限(IUGR),在发达国家,胎盘功能不全是最常见的原因。虽然已知早产儿会发生白质损伤,但足月婴儿中IUGR对白质损伤的影响程度尚不清楚。我们使用了一种新型小鼠模型,该模型利用血栓素A2(TXA2)类似物(U46619)(一种强效血管收缩剂)诱导母体高血压,并模拟人类胎盘功能不全诱导的IUGR来研究白质。我们还研究了高氧作为白质损伤的另一个危险因素的作用,因为IUGR婴儿发生呼吸合并症的风险增加,导致氧暴露增加。我们发现,TXA2类似物诱导的IUGR会导致白质损伤,这表现为髓鞘结构改变和少突胶质细胞/少突胶质细胞群体的变化。此外,我们的研究表明,暴露于高氧会独立导致白质紊乱。据我们所知,这是第一项报告IUGR与高氧对白质和运动功能的单一及联合影响的研究。这些结果提醒人们,需要在出院后密切监测IUGR婴儿的运动发育,同时强调在临床可行的情况下限制氧过度暴露程度的重要性,以潜在改善这一群体婴儿的运动结局。