White matter injury in infants with intraventricular haemorrhage: mechanisms and therapies.
White matter injury in infants with intraventricular haemorrhage: mechanisms and therapies.
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DOI：
10.1038/s41582-020-00447-8
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
de Vries LS
中科院分区：
文献类型：
--
作者：
Ballabh P;de Vries LS
脑室内出血（IVH）仍然是早产儿的主要并发症，可导致幸存者的脑瘫和认知障碍。目前还没有批准的治疗方法来预防IVH或治疗其后果。IVH的严重程度各不相同，可以表现为局限于生殖基质的出血、小到大的IVH或脑室周围出血性梗死。中度至重度出血使心室扩张，也损害了脑室周围的白色物质。这种白色物质损伤（white matter injury，WTH）是由一系列血液诱导的病理反应引起的，包括氧化应激、谷氨酸兴奋性毒性、炎症、干扰的信号传导通路和细胞外基质的重塑。IVH的潜在疗法目前正在临床前模型中进行研究，来自临床试验的证据表明，干细胞治疗和/或内窥镜下清除脑室中的凝块可以改变IVH婴儿的结局。本文综述了对IVH早产儿发生脑卒中机制的新认识，并强调了早期发现残疾和立即干预对IVH幸存者结局的重要性。
Intraventricular haemorrhage (IVH) continues to be a major complication of prematurity that can result in cerebral palsy and cognitive impairments in survivors. No approved therapy exists to prevent IVH or to treat its consequences. IVH varies in severity and can present as a bleed confined to the germinal matrix, small-to-large IVH or periventricular haemorrhagic infarction. Moderate-to-severe haemorrhage dilates the ventricle and also damages the periventricular white matter. This white matter injury (WMI) results from a constellation of blood-induced pathological reactions, including oxidative stress, glutamate excitotoxicity, inflammation, perturbed signaling pathways and remodeling of the extracellular matrix. Potential therapies for IVH are currently undergoing investigation in preclinical models, and evidence from clinical trials suggests that stem cell treatment and/or endoscopic removal of clots from the cerebral ventricles could transform the outcome of infants with IVH. This Review presents an integrated view of new insights into the mechanisms underlying WMI in premature infants with IVH and highlights the importance of early detection of disability and immediate intervention in optimizing the outcomes of IVH survivors.
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DOI：
10.1001/archpedi.1987.04460060035027
发表时间：
1987-06-01
影响因子：
--
作者：
ARMSTRONG, DL;SAULS, CD;GODDARDFINEGOLD, J
通讯作者：
GODDARDFINEGOLD, J
影响因子：
9.9
作者：
Cayam-Rand, Dalit;Guo, Ting;Miller, Steven P.
通讯作者：
Miller, Steven P.
影响因子：
6
作者：
Ahn SY;Chang YS;Sung SI;Park WS
通讯作者：
Park WS
影响因子：
5.1
作者：
Cizmeci, Mehmet N.;Groenendaal, Floris;de Vries, Linda S.
通讯作者：
de Vries, Linda S.
影响因子：
8.3
作者：
Back, Stephen A.;Riddle, Art;McClure, Melissa M.
通讯作者：
McClure, Melissa M.