Complex interactions between hypoxia‐ischemia and inflammation in preterm brain injury. (1st December 2017)

• Record Type: Journal Article
• Authors: Galinsky, Robert; Lear, Christopher A; Dean, Justin M; Wassink, Guido; Dhillon, Simerdeep K; Fraser, Mhoyra; Davidson, Joanne O; Bennet, Laura; Gunn, Alistair J
• Is Part Of: Developmental medicine & child neurology. Volume 60:Number 2(2018)
• Page Start: 126
• Page End: 133
• Publication Date: 2017-12-01
• Subjects: Child development -- Periodicals; Pediatric neurology -- Periodicals; 616.8
• DOI: 10.1111/dmcn.13629
• Languages: English
• ISSNs: 0012-1622

Abstract

Abstract : Children surviving preterm birth have a high risk of disability, particularly cognitive and learning problems. There is extensive clinical and experimental evidence that disability is now primarily related to dysmaturation of white and gray matter, defined by failure of oligodendrocyte maturation and neuronal dendritic arborization, rather than cell death alone. The etiology of this dysmaturation is multifactorial, with contributions from hypoxia‐ischemia, infection/inflammation and barotrauma. Intriguingly, these factors can interact to both increase and decrease damage. In this review we summarize preclinical and clinical evidence that all of these factors trigger secondary or chronic inflammation and gliosis. Thus, we hypothesize that these shared pathological features play a key role in a final common pathway that leads to the impaired neural maturation and connectivity and cognitive/motor impairments that are commonly observed in infants born preterm. This raises the possibility that secondary or chronic inflammation may be a viable therapeutic target for delayed interventions to improve neurodevelopmental outcomes after preterm birth. What this paper adds: Hypoxia‐ischemia, infection/inflammation, and barotrauma/volutrauma all contribute to preterm brain injury. Multiple different triggers of preterm brain injury are associated with central nervous system dysmaturation. Secondary brain inflammation may be a viable target to improve neurodevelopment after preterm birth. What this paper adds: Hypoxia‐ischemia, infection/inflammation, and barotrauma/volutrauma all contribute to preterm brain injury. Multiple different triggers of preterm brain injury are associated with central nervous system dysmaturation. Secondary brain inflammation may be a viable target to improve neurodevelopment after preterm birth. This article is commented on by Paneth on page115 of this issue. This article's abstract has been translated into Spanish and Portuguese. Follow the links from theabstract to view the translations.