Komiotis Christodoulos, Mavridis Ioannis
School of Medicine, Faculty of Health Sciences, Democritus University of Thrace, Alexandroupolis, Greece.
Pediatric Neurosurgery Unit, Department of Neurosurgery, School of Medicine, Faculty of Health Sciences, Democritus University of Thrace, University General Hospital of Alexandroupolis, 68100, Alexandroupolis, Greece.
Childs Nerv Syst. 2024 Dec 9;41(1):40. doi: 10.1007/s00381-024-06703-2.
Neonatal intraventricular hemorrhage (IVH) is a common complication of prematurity as it affects 12.4% of preterm infants weighing under 1500 g. Posthemorrhagic hydrocephalus (PHH) is an important complication of neonatal IVH and can have serious long-term consequences such as cognitive impairment and cerebral palsy. The purpose of this review is to determine whether stem cell transplantation can play a role in the treatment of neonatal IVH mainly focusing on the prevention of the catastrophic sequelae of neonatal IVH, as well as to the improve outcome of these patients.
A literature search was performed using the PubMed/MEDLINE and Scopus databases, and after meticulous screening, eight articles were finally selected. The authors included both animal and human studies in this narrative review.
Our review included eight articles, five animal studies and three human studies, including one phase 1 clinical trial, one pilot study, and one case report. Intraventricular transplantation of mesenchymal stem cells (MSCs) early after IVH diagnosis seems to prevent the development of PHH, improve myelination, and reduce periventricular cell death, inflammation, and reactive gliosis. It also seems to be a safe and well-tolerated procedure in preterm infants.
Animal and human study findings regarding stem cell transplantation in the treatment of IVH show promising results in reducing the risk of PHH. Further research with larger series is needed to better determine its safety and efficacy. Larger studies such as randomized controlled trials could establish the efficacy and tolerability of the treatment.
新生儿脑室内出血（IVH）是早产常见的并发症，影响12.4%体重低于1500克的早产儿。出血后脑积水（PHH）是新生儿IVH的重要并发症，可产生严重的长期后果，如认知障碍和脑瘫。本综述的目的是确定干细胞移植是否能在新生儿IVH的治疗中发挥作用，主要关注预防新生儿IVH的灾难性后遗症，以及改善这些患者的预后。
使用PubMed/MEDLINE和Scopus数据库进行文献检索，经过细致筛选，最终选定8篇文章。在这篇叙述性综述中，作者纳入了动物和人体研究。
我们的综述纳入8篇文章，5项动物研究和3项人体研究，包括1项1期临床试验、1项试点研究和1例病例报告。IVH诊断后早期脑室内移植间充质干细胞（MSCs）似乎可预防PHH的发生，改善髓鞘形成，并减少脑室周围细胞死亡、炎症和反应性胶质增生。在早产儿中，这似乎也是一种安全且耐受性良好的操作。
关于干细胞移植治疗IVH的动物和人体研究结果显示，在降低PHH风险方面有令人鼓舞的结果。需要开展更大规模的系列研究，以更好地确定其安全性和有效性。诸如随机对照试验等更大规模的研究可以确定该治疗方法的有效性和耐受性。
