Fleiss Bobbi, Wong Flora, Brownfoot Fiona, Shearer Isabelle K, Baud Olivier, Walker David W, Gressens Pierre, Tolcos Mary
School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia.
NeuroDiderot, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
Front Endocrinol (Lausanne). 2019 Mar 29;10:188. doi: 10.3389/fendo.2019.00188. eCollection 2019.
Intrauterine growth restriction (IUGR) is a complex global healthcare issue. Concerted research and clinical efforts have improved our knowledge of the neurodevelopmental sequelae of IUGR which has raised the profile of this complex problem. Nevertheless, there is still a lack of therapies to prevent the substantial rates of fetal demise or the constellation of permanent neurological deficits that arise from IUGR. The purpose of this article is to highlight the clinical and translational gaps in our knowledge that hamper our collective efforts to improve the neurological sequelae of IUGR. Also, we draw attention to cutting-edge tools and techniques that can provide novel insights into this disorder, and technologies that offer the potential for better drug design and delivery. We cover topics including: how we can improve our use of crib-side monitoring options, what we still need to know about inflammation in IUGR, the necessity for more human post-mortem studies, lessons from improved integrated histology-imaging analyses regarding the cell-specific nature of magnetic resonance imaging (MRI) signals, options to improve risk stratification with genomic analysis, and treatments mediated by nanoparticle delivery which are designed to modify specific cell functions.
宫内生长受限（IUGR）是一个复杂的全球性医疗保健问题。协同的研究和临床努力增进了我们对IUGR神经发育后遗症的了解，这提高了这个复杂问题的受关注程度。然而，仍然缺乏预防IUGR导致的高胎儿死亡率或一系列永久性神经功能缺损的疗法。本文的目的是强调我们在知识方面存在的临床和转化差距，这些差距阻碍了我们为改善IUGR神经后遗症而做出的共同努力。此外，我们还关注能够为这种疾病提供新见解的前沿工具和技术，以及具有改进药物设计和给药潜力的技术。我们涵盖的主题包括：如何更好地利用床边监测选项，我们对IUGR炎症仍需了解的内容，更多人体尸检研究的必要性，关于磁共振成像（MRI）信号细胞特异性本质的改进综合组织学 - 成像分析的经验教训，通过基因组分析改善风险分层的选项，以及旨在改变特定细胞功能的纳米颗粒递送介导的治疗方法。
