Mondal Victor, Ross-Munro Emily, Balasuriya Gayathri K, Kumari Ritu, Hossen Md Munnaf, Ageeli Mohammed, Firipis Kate, Nisbet David R, King Glenn F, Williams Richard J, Gressens Pierre, Cheong Jeanie L Y, Wong Flora Y, Walker David W, Tolcos Mary, Fleiss Bobbi
School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia.
O'Brien Department, St Vincent's Institute for Medical Research, Fitzroy, VIC 3065, Australia.
Cells. 2025 Jun 16;14(12):910. doi: 10.3390/cells14120910.
Within the first 28 days after birth, more than 1 in every 2500 newborns will suffer a stroke. The weekly-adjusted risk of stroke for a term-born infant is threefold higher than for a male smoker aged 50 to 59 years with hypertension and diabetes. Neonatal stroke has significant clinical and socio-economic consequences, leading to cerebral palsy, epilepsy, and a range of motor, sensory, and cognitive impairments. Currently, there is no treatment for the brain damage caused by neonatal stroke. In this review, we outline the differences in the complex interplay of inflammation, excitotoxicity, oxidative stress, and cell death after stroke between adults and neonates, which limits the direct transfer of knowledge between studies for understanding injury. We comprehensively document what is known about the pathophysiology of neonatal stroke and critically evaluate current therapeutic strategies, emphasising the urgent need for innovative treatments tailored to suit the neonatal brain. This analysis reveals that treatment with an injectable hydrogel scaffold, a three-dimensional, water-swollen polymer network, may be an innovative, viable approach to improve outcomes for infants suffering from the most severe forms of brain injury arising from neonatal stroke.
在出生后的头28天内，每2500名新生儿中就有超过1名会发生中风。足月儿中风的每周调整风险比患有高血压和糖尿病的50至59岁男性吸烟者高出两倍。新生儿中风会产生重大的临床和社会经济后果，导致脑瘫、癫痫以及一系列运动、感觉和认知障碍。目前，尚无针对新生儿中风所致脑损伤的治疗方法。在本综述中，我们概述了成人和新生儿中风后炎症、兴奋性毒性、氧化应激和细胞死亡之间复杂相互作用的差异，这限制了不同研究之间关于损伤认识的直接知识转移。我们全面记录了已知的新生儿中风病理生理学知识，并批判性地评估了当前的治疗策略，强调迫切需要针对新生儿大脑量身定制的创新治疗方法。该分析表明，使用可注射水凝胶支架（一种三维、水溶胀聚合物网络）进行治疗，可能是一种创新且可行的方法，可改善因新生儿中风导致最严重脑损伤形式的婴儿的预后。
