Di Sarno Lorenzo, Ferretti Serena, Capossela Lavinia, Gatto Antonio, Pansini Valeria, Caroselli Anya, Manni Luigi, Soligo Marzia, Chiaretti Antonio
Department of Pediatrics, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, 00168 Rome, Italy.
Department of Pediatrics, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Pharmaceuticals (Basel). 2025 Jun 19;18(6):929. doi: 10.3390/ph18060929.
Traumatic brain injury (TBI) and hypoxic-ischemic encephalopathy (HIE) are major causes of long-term neurological disability in children, with limited options for effective neuronal recovery. Recent research has highlighted the therapeutic potential of nerve growth factor (NGF) in promoting neural repair through mechanisms such as neuroprotection, neurogenesis, and the modulation of neuroinflammation. This review evaluates the current evidence on NGF as a treatment strategy for pediatric brain injury, emphasizing its mechanisms of action and translational clinical applications. A comprehensive review was conducted using the PubMed, Scopus, and Cochrane CENTRAL databases to identify studies published between 1 January 1978 and 1 March 2025, investigating NGF in the context of brain injury. The inclusion criteria comprised studies assessing neurological outcomes through clinical scales, biochemical markers, neuroimaging, or electrophysiological examinations. Seventeen studies met the inclusion criteria, encompassing both preclinical and clinical research. Preclinical models consistently demonstrated that NGF administration reduces neuroinflammation, enhances neurogenesis, and supports neuronal survival following TBI and HIE. Clinical studies, including case reports of pediatric patients treated with intranasal NGF, reported improvements in motor and cognitive function, neuroimaging findings, and electrophysiological parameters, with no significant adverse effects observed. NGF demonstrates significant promise as a neuroprotective and neuroregenerative agent in pediatric brain injury, with both experimental and early clinical evidence supporting its safety and efficacy. Large-scale controlled clinical trials are warranted to validate these preliminary findings and to determine the optimal dosage regimens and administration schedules for NGF in the treatment of TBI and HIE.
创伤性脑损伤(TBI)和缺氧缺血性脑病(HIE)是儿童长期神经功能残疾的主要原因,有效促进神经元恢复的选择有限。最近的研究强调了神经生长因子(NGF)通过神经保护、神经发生和神经炎症调节等机制促进神经修复的治疗潜力。本综述评估了NGF作为小儿脑损伤治疗策略的现有证据,重点阐述其作用机制及临床转化应用。使用PubMed、Scopus和Cochrane CENTRAL数据库进行了全面检索,以识别1978年1月1日至2025年3月1日期间发表的、在脑损伤背景下研究NGF的文献。纳入标准包括通过临床量表、生化标志物、神经影像学或电生理检查评估神经学结果的研究。17项研究符合纳入标准,涵盖临床前和临床研究。临床前模型一致表明,给予NGF可减轻TBI和HIE后的神经炎症、增强神经发生并支持神经元存活。临床研究,包括鼻内给予NGF治疗小儿患者的病例报告,显示运动和认知功能、神经影像学结果及电生理参数有所改善,且未观察到明显不良反应。NGF作为小儿脑损伤的神经保护和神经再生剂显示出巨大潜力,实验和早期临床证据均支持其安全性和有效性。有必要开展大规模对照临床试验以验证这些初步发现,并确定NGF治疗TBI和HIE的最佳剂量方案和给药时间表。