Departamento de Fisiología y Farmacología, Laboratorio de Neurofisiología, Centro de Ciencias Básicas, Universidad Autónoma de Aguascalientes, Aguascalientes, México.
Departamento de Morfología, Centro de Ciencias Básicas, Universidad Autónoma de Aguascalientes, Aguascalientes, México.
Neuropediatrics. 2022 Dec;53(6):402-417. doi: 10.1055/s-0042-1755235. Epub 2022 Aug 28.
Hypoxic-ischemic encephalopathy (HIE) is a serious condition that could have deleterious neurological outcomes, such as cerebral palsy, neuromotor disability, developmental disability, epilepsy, and sensitive or cognitive problems, and increase the risk of death in severe cases. Once HIE occurs, molecular cascades are triggered favoring the oxidative stress, excitotoxicity, and inflammation damage that promote cell death via apoptosis or necrosis. Currently, the therapeutic hypothermia is the standard of care in HIE; however, it has a small window of action and only can be used in children of more than 36 gestational weeks; for this reason, it is very important to develop new therapies to prevent the progression of the hypoxic-ischemic injury or to develop neuroregenerative therapies in severe HIE cases. The objective of this revision is to describe the emerging treatments for HIE, either preventing cell death for oxidative stress, excitotoxicity, or exacerbated inflammation, as well as describing a new therapeutic approach for neuroregeneration, such as mesenchymal stem cells, brain-derived neurotrophic factor, and gonadotropin realizing hormone agonists.
缺氧缺血性脑病（HIE）是一种严重的疾病，可能导致神经系统不良后果，如脑瘫、运动障碍、发育障碍、癫痫以及敏感或认知问题，并增加严重情况下的死亡风险。一旦发生 HIE，就会触发分子级联反应，有利于氧化应激、兴奋毒性和炎症损伤，通过细胞凋亡或坏死促进细胞死亡。目前，治疗性低温是 HIE 的标准治疗方法；然而，它的作用窗口很小，只能用于妊娠 36 周以上的儿童；因此，开发新的治疗方法来预防缺氧缺血性损伤的进展或在严重 HIE 病例中开发神经再生治疗方法非常重要。本次修订的目的是描述 HIE 的新兴治疗方法，这些方法要么预防氧化应激、兴奋毒性或炎症加剧引起的细胞死亡，要么描述一种新的神经再生治疗方法，如间充质干细胞、脑源性神经营养因子和促性腺激素释放激素激动剂。
