Neurological consequences of systemic inflammation in the premature neonate.
Neurological consequences of systemic inflammation in the premature neonate.
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DOI：
10.4103/1673-5374.208547
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发表时间：
2017-06
影响因子：
6.1
通讯作者：
Giannone PJ
中科院分区：
文献类型：
--
作者：
Patra A;Huang H;Bauer JA;Giannone PJ
尽管在过去二十年中，新生儿护理取得了实质性进展，导致极早产婴儿的存活率提高，但极早产仍然与长期神经发育障碍有关。脑白质损伤是早产儿脑损伤的主要形式，可导致不良的神经系统后果。这种脑损伤模式和不利的神经系统后遗症常见于暴露于全身性炎症状态的早产儿，如临床或培养证实的败血症，伴或不伴脑膜炎、长时间机械通气、支气管肺发育不良、坏死性小肠结肠炎和绒毛膜羊膜炎。潜在的机制可能包括细胞因子介导的过程，而不是病原体直接进入大脑，免疫反应的发育差异和复杂的神经血管屏障系统在调节早产儿对各种全身炎症损伤的大脑反应中发挥关键作用。基于血清生物标志物或磁共振成像的脑成像发现，了解这些损伤的病理机制和临床相关性，将为未来的研究和发育中的大脑的转化治疗机会铺平道路。
Despite substantial progress in neonatal care over the past two decades leading to improved survival of extremely premature infants, extreme prematurity continues to be associated with long term neurodevelopmental impairments. Cerebral white matter injury is the predominant form of insult in preterm brain leading to adverse neurological consequences. Such brain injury pattern and unfavorable neurologic sequelae is commonly encountered in premature infants exposed to systemic inflammatory states such as clinical or culture proven sepsis with or without evidence of meningitis, prolonged mechanical ventilation, bronchopulmonary dysplasia, necrotizing enterocolitis and chorioamnionitis. Underlying mechanisms may include cytokine mediated processes without direct entry of pathogens into the brain, developmental differences in immune response and complex neurovascular barrier system that play a critical role in regulating the cerebral response to various systemic inflammatory insults in premature infants. Understanding of these pathologic mechanisms and clinical correlates of such injury based on serum biomarkers or brain imaging findings on magnetic resonance imaging will pave way for future research and translational therapeutic opportunities for the developing brain.
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影响因子：
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DOI：
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