Commentary to the in-focus issue "Perinatal brain injury leading to later neurodevelopmental disorders: Early detection and treatment options".
Commentary to the in-focus issue "Perinatal brain injury leading to later neurodevelopmental disorders: Early detection and treatment options".
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DOI：
10.1002/jnr.25130
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发表时间：
2022-12
影响因子：
4.2
通讯作者：
Shi, Zhongjie
中科院分区：
文献类型：
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作者：
Tan, Sidhartha;Shi, Zhongjie
本期向读者介绍了一系列涉及新生儿脑病的重要问题：从不同的动物模型到神经保护和临床生物标志物。论文集是重要的，因为读者获得了围产期脑损伤景观的鸟瞰图，以及处理翻译和临床问题的各种细微差别。罗宾逊和同事报道了出生后腹膜内施用促红细胞生成素对胎盘功能不全大鼠模型中成人认知缺陷的有益作用（罗宾逊等人，2021年）。这篇文章值得注意的是，不仅关注功能结果，而且关注产前损伤后的成人认知结果。此外，正确使用触摸屏技术来测试动物的行为和认知功能。成人结果的转化意义表明，NIH资助的5年周期可能难以确定产前损伤后有前途的产后神经保护剂的明确益处。读者不禁要问，在24- 32周早产儿的EPO试验中，在2岁时死亡或严重神经发育障碍方面缺乏益处是否与24- 32周早产儿的死亡或严重神经发育障碍有关（Juul等人，2020）和最近发表的静脉内给予高剂量促红细胞生成素治疗窒息性脑病（HEAL）试验的临床试验（Wu et al.，2022年）可能是因为不可能有更长的随访期。重要的是，罗宾逊的文章揭示了成人认知结果和视觉系统缺陷的性别差异。为了估计E18时60分钟子宫缺血的严重程度，该小组先前的出版物（Jantzie等人，2013年）提到了23%的胎儿丢失，但没有提到任何新生儿死亡。严重的产前损伤通常会导致产后死亡。在本研究中，可能所有新生儿存活者都达到成年期，这意味着在出生后EPO给药时，脑损伤的状态可能更新为轻度至中度严重程度。此外，罗宾逊的文章中使用的剂量，在P1-P5大鼠中连续5天ip 2000 U/kg剂量，与在人类新生儿中的HEAL试验中使用的剂量，在1、2、3、4和7天iv 1000 U/kg剂量相比，大约是两倍（Wu
This issue introduces the reader to a range of important issues that involve neonatal encephalopathy: from different animal models to neuroprotection and clinical biomarkers. The collection of papers is important because the reader obtains a bird’s eye view of the landscape of perinatal brain injury, and also, the various nuances in dealing with translational and clinical issues.Robinson and colleagues report on the beneficial effects of postnatal intraperitoneal erythropoietin administration on adult cognitive deficits in a rat model of placental insufficiency (Robinson et al., 2021). This article is notable not only for focusing on functional outcomes, but also for focusing on adult cognitive outcomes after a prenatal insult. Furthermore, the proper use of touch screen technique to test the animal behavior and cognitive function is presented. The translational implication of adult outcomes suggests that the 5-year cycles of NIH funding may make it difficult to establish clear-cut benefits of a promising postnatal neuroprotectant following a prenatal insult. The reader is left to wonder whether the absence of benefit in death or severe neurodevelopmental impairment at 2 years of age in the EPO trial in 24-to 32-week premature infants (Juul et al., 2020) and in the recently published clinical trial of high-dose-erythropoietin-for-asphyxiaand-encephalopathy (HEAL) trial given intravenously (Wu et al., 2022) could be because a longer follow-up period was not possible. Importantly, Robinson’s article uncovers sex differences in adult cognitive outcomes and the deficits in the visual system. To estimate the severity of the 60-min uterine ischemia at E18, the previous publication by the group (Jantzie et al., 2013) mentioned a fetal loss of 23% but did not mention any newborn deaths. A severe prenatal insult would usually result in postnatal deaths. The implication of possibly all newborn survivors reaching adulthood in the present study is that the status of brain injury probably updated to a mild-to-moderate severity at the time of postnatal EPO administration. Also, the dosage used in the Robinson’s article, 2000 U/kg dose ip for 5 consecutive days in P1–P5 rats, is roughly double when compared to that used in the HEAL trial in human newborns, 1000 U/kg iv dose on 1, 2, 3, 4, and 7 days (Wu
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影响因子：
4.2
作者：
Dettman RW;Dizon MLV
通讯作者：
Dizon MLV
影响因子：
4.2
作者：
Shi Z;Luo K;Jani S;February M;Fernandes N;Venkatesh N;Sharif N;Tan S
通讯作者：
Tan S
影响因子：
4.2
作者：
Shi, Zhongjie;Luo, Kehuan;Deol, Saihaj;Tan, Sidhartha
通讯作者：
Tan, Sidhartha
影响因子：
5.6
作者：
Nguyen, Ly M.;Singh, Aman P.;Krzyzanski, Wojciech
通讯作者：
Krzyzanski, Wojciech
DOI：
10.1056/nejmoa2119660
发表时间：
2022-07-14
期刊：
The New England journal of medicine
影响因子：
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作者：
通讯作者：
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