Marques Kethely L, Rodrigues Victor, Balduci Cassiana T N, Montes Guilherme C, Barradas Penha C, Cunha-Rodrigues Marta C
Laboratory of Neurobiology, Pharmacology and Psychobiology Department, Roberto Alcantara Gomes Biology Institute, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
Front Pharmacol. 2024 Feb 26;15:1347529. doi: 10.3389/fphar.2024.1347529. eCollection 2024.
Perinatal hypoxia-ischemia represents a significant risk to CNS development, leading to high mortality rates, diverse damages, and persistent neurological deficits. Despite advances in neonatal medicine in recent decades, the incidence of HIE remains substantial. Motor deficits can manifest early, while cognitive impairments may be diagnosed later, emphasizing the need for extended follow-up. This review aims to explore potential candidates for therapeutic interventions for hypoxic-ischemic encephalopathy (HIE), with a focus on cognitive deficits. We searched randomized clinical trials (RCT) that tested drug treatments for HIE and evaluated cognitive outcomes. The results included studies on erythropoietin, melatonin, magnesium sulfate, topiramate, and a combination of vitamin C and ibuprofen. Although there are several indications of the efficacy of these drugs among animal models, considering neuroprotective properties, the RCTs failed to provide complete effectiveness in the context of cognitive impairments derived from HIE. More robust RCTs are still needed to advance our knowledge and to establish standardized treatments for HIE.
围产期缺氧缺血对中枢神经系统发育构成重大风险，导致高死亡率、多种损害及持续性神经功能缺损。尽管近几十年来新生儿医学取得了进展，但缺氧缺血性脑病（HIE）的发病率仍然很高。运动功能缺损可能早期就会出现，而认知障碍可能在后期才被诊断出来，这凸显了延长随访的必要性。本综述旨在探索针对缺氧缺血性脑病（HIE）的治疗干预潜在候选药物，重点关注认知缺陷。我们检索了测试HIE药物治疗并评估认知结局的随机临床试验（RCT）。结果包括有关促红细胞生成素、褪黑素、硫酸镁、托吡酯以及维生素C和布洛芬联合用药的研究。尽管在动物模型中有若干迹象表明这些药物具有疗效，但考虑到神经保护特性，在由HIE引起的认知障碍方面，RCT未能提供完全有效的证据。仍需要更有力的RCT来增进我们的认识，并建立HIE的标准化治疗方法。
