How lung injury and therapeutic oxygen could alter white matter development.
How lung injury and therapeutic oxygen could alter white matter development.
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DOI：
10.1002/jnr.24816
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发表时间：
2022-12
影响因子：
4.2
通讯作者：
Dizon MLV
中科院分区：
文献类型：
--
作者：
Dettman RW;Dizon MLV
发育性脑损伤描述了由产前或围产期损伤引起的一系列神经病理。这包括影响患者一生的认知和运动缺陷。发育性脑损伤可由一系列情况引起，包括中风、围产期缺氧缺血和颅内出血。已确定的其他危险因素包括极低出生体重、机械通风和补充氧气(O2)。事实上，患有支气管肺发育不良的婴儿，一种与肺发育中断相关的炎症性疾病，已被证明减少了脑白质和减少了颅内体积。因此，肺、氧气和大脑之间似乎存在发育联系，从而导致适当的髓鞘形成。在这里，我们将讨论目前已知的氧气和髓鞘形成之间的联系，以及科学家如何探索补充氧气和/或肺损伤可以影响大脑发育的机制。考虑到患病的肺部和大脑发育之间的联系，将使临床医生能够微调他们在管理早产儿肺部疾病方面的方法，以优化大脑健康。在这里，我们回顾文献，阐明高氧水平和/或肺损伤，如支气管肺发育不良，可导致神经发育障碍的可能性。文献特别令人信服的是，这些因素影响极早产或极低出生体重儿的神经发育。
Developmental brain injury describes a spectrum of neurological pathologies resulting from either antenatal or perinatal injury. This includes both cognitive and motor defects that affect patients for their entire lives. Developmental brain injury can be caused by a spectrum of conditions including stroke, perinatal hypoxia-ischemia and intracranial haemorrhage. Additional risk factors have been identified including very low birthweight, mechanical ventilation and oxygen (O2) supplementation. In fact, infants with bronchopulmonary dysplasia, an inflammatory disease associated with disrupted lung development, have been shown to have decreased cerebral white matter and decreased intracranial volumes. Thus, there appears to be a developmental link between the lung, O2 and the brain that leads to proper myelination. Here, we will discuss what is currently known about the link between O2 and myelination and how scientists are exploring mechanisms through which supplemental O2 and/or lung injury can affect brain development. Consideration of a link between the diseased lung and developing brain will allow clinicians to fine tune their approaches in managing preterm lung disease in order to optimize brain health. Here we review the literature to shed light on the possibility that high oxygen levels and/or lung injury, such as bronchopulmonary dysplasia, can lead to neurodevelopmental impairment. The literature is especially convincing that these factors affect the neurodevelopment of extremely preterm or very low birthweight infants.
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