Synergistic neuroprotective therapies with hypothermia.

Synergistic neuroprotective therapies with hypothermia.
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DOI:
10.1016/j.siny.2010.02.002
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发表时间:
2010-10
影响因子:
3
通讯作者:
Ferriero, Donna M.
Ferriero, Donna M.
中科院分区:
医学3区
文献类型:
--
作者:
Cilio, Maria Roberta;Ferriero, Donna M.

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鉴于围产期脑损伤造成的人类痛苦和经济成本的巨大负担,神经保护是一个主要的卫生保健优先事项。随着低温治疗足月缺氧缺血性脑病的出现,新生儿严重损伤后的大脑修复和保护有望实现。然而,从已发表的临床试验和动物研究中可以清楚地看出,单独的低温不能提供完全的保护或刺激正常神经发育结果所必需的修复。这篇综述批判性地讨论了用于治疗新生儿缺氧缺血后癫痫发作的药物,并关注治疗可能协同作用的证据。此外,其他代理商,如氙,N-乙酰半胱氨酸,促红细胞生成素,褪黑激素和大麻素作为未来的潜在治疗剂,可能会增加保护体温过低进行了讨论。最后,化合物可能会损害发育中的大脑或抵消低温的神经保护作用进行了讨论。
Neuroprotection is a major health care priority, given the enormous burden of human suffering and financial cost caused by perinatal brain damage. With the advent of hypothermia as therapy for term hypoxic–ischemic encephalopathy, there is hope for repair and protection of the brain after a profound neonatal insult. However, it is clear from the published clinical trials and animal studies that hypothermia alone will not provide complete protection or stimulate the repair that is necessary for normal neurodevelopmental outcome. This review critically discusses drugs used to treat seizures after hypoxia–ischemia in the neonate with attention to evidence of possible synergies for therapy. In addition, other agents such as xenon, N-acetylcysteine, erythropoietin, melatonin and cannabinoids are discussed as future potential therapeutic agents that might augment protection from hypothermia. Finally, compounds that might damage the developing brain or counteract the neuroprotective effects of hypothermia are discussed.
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