Neuroprotection for neonatal hypoxic-ischemic encephalopathy: A review of novel therapies evaluated in clinical studies.

IF 3.8 2区 医学 Q1 CLINICAL NEUROLOGY
Natalie H Chan, Cheryl C Hawkins, Benjamin V Rodrigues, Marie-Coralie Cornet, Fernando F Gonzalez, Yvonne W Wu
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引用次数: 0

Abstract

Therapeutic hypothermia is an effective therapy for moderate-to-severe hypoxic-ischemic encephalopathy (HIE) in infants born at term or near-term in high-resource settings. Yet there remains a substantial proportion of infants who do not benefit or who will have significant disability despite therapeutic hypothermia. Novel investigational therapies that may confer additional neuroprotection by targeting known pathogenic mechanisms of hypoxic-ischemic brain injury are under development. This review focuses on putative neuroprotective agents that have shown promise in animal models of HIE, and that have been translated to clinical studies in neonates with HIE. We include agents that have been studied both with and without concurrent therapeutic hypothermia. Our review therefore addresses not just neonatal HIE in high-resource countries where therapeutic hypothermia is the standard of care, but also neonatal HIE in low- and middle-income countries where therapeutic hypothermia has been shown to be ineffective, and where the greatest burden of HIE-related morbidity and mortality exists.

新生儿缺氧缺血性脑病的神经保护:临床研究中评估的新型疗法综述。
在资源丰富的地区,治疗性低温疗法是治疗足月或临近足月新生儿中重度缺氧缺血性脑病(HIE)的有效疗法。然而,仍有相当一部分婴儿尽管接受了治疗性低温,但仍无法从中获益或严重残疾。针对缺氧缺血性脑损伤的已知致病机制,可提供额外神经保护的新型研究疗法正在开发中。本综述将重点讨论在 HIE 动物模型中显示出前景,并已转化为 HIE 新生儿临床研究的潜在神经保护药物。我们将同时使用和不使用治疗性低温的药物纳入研究范围。因此,我们的综述不仅涉及高资源国家的新生儿 HIE,因为在这些国家,治疗性低温是标准护理方法,而且还涉及中低收入国家的新生儿 HIE,因为在这些国家,治疗性低温已被证明无效,而且 HIE 相关发病率和死亡率对这些国家造成的负担最大。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.80
自引率
13.20%
发文量
338
审稿时长
3-6 weeks
期刊介绍: Wiley-Blackwell is pleased to publish Developmental Medicine & Child Neurology (DMCN), a Mac Keith Press publication and official journal of the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) and the British Paediatric Neurology Association (BPNA). For over 50 years, DMCN has defined the field of paediatric neurology and neurodisability and is one of the world’s leading journals in the whole field of paediatrics. DMCN disseminates a range of information worldwide to improve the lives of disabled children and their families. The high quality of published articles is maintained by expert review, including independent statistical assessment, before acceptance.
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