76 Efficacy of a Feeding Guideline Based Upon Gastric Emptying

Knight, D; Durward, Andrew; Thruston, I M; Larmour, Kelly; Tibby, Shane M.

doi:10.1203/00006450-201011001-00076

Cited by 5 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We show for the first time that this preconditioning effect was associated with upregulation of mRNA for TLR4, TLR7 and IFN-β, and a considerable increase in plasma IFN-β levels, suggesting the possibility that IFN-β may be an important mediator of endogenous neuroprotection. These findings have potential clinical relevance since it is widely speculated that subclinical infection and HI may act in concert to exacerbate preterm brain injury [14,17,56,57,58,59,60]. …”

Section: Discussionmentioning

confidence: 93%

“…This complexity is mirrored by preclinical evidence in the neonatal rat that single-dose exposure to lipopolysaccharide (LPS) can either protect or sensitize to injury from other insults [13,14,15,16,17], depending on the time interval between exposure to infection and subsequent ischemia. Typically, single-dose administration of LPS 24 h before HI is neuroprotective, whereas LPS given 4 and 72 h before HI exacerbates injury [13,18].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Lipopolysaccharide-Induced Preconditioning Attenuates Apoptosis and Differentially Regulates TLR4 and TLR7 Gene Expression after Ischemia in the Preterm Ovine Fetal Brain

Dhillon

Gunn

Jung³

et al. 2015

Dev Neurosci

View full text Add to dashboard Cite

Acute exposure to subclinical infection modulates subsequent hypoxia-ischemia (HI) injury in a time-dependent manner, likely by cross-talk through Toll-like receptors (TLRs), but the specific pathways are unclear in the preterm-equivalent brain. In the present study, we tested the hypothesis that repeated low-dose exposure to lipopolysaccharide (LPS) before acute ischemia would be associated with induction of specific TLRs that are potentially neuroprotective. Fetal sheep at 0.65 gestation (term is ∼145 days) received intravenous boluses of low-dose LPS for 5 days (day 1, 50 ng/kg; days 2-5, 100 ng/kg) or the same volume of saline. Either 4 or 24 h after the last bolus of LPS, complete carotid occlusion was induced for 22 min. Five days after LPS, brains were collected. Pretreatment with LPS for 5 days decreased cellular apoptosis, microglial activation and reactive astrogliosis in response to HI injury induced 24 but not 4 h after the last dose of LPS. This was associated with upregulation of TLR4, TLR7 and IFN-β mRNA, and increased fetal plasma IFN-β concentrations. The association of reduced white matter apoptosis and astrogliosis after repeated low-dose LPS finishing 24 h but not 4 h before cerebral ischemia, with central and peripheral induction of IFN-β, suggests the possibility that IFN-β may be an important mediator of endogenous neuroprotection in the developing brain.

show abstract

Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Lipopolysaccharide-Induced Preconditioning Attenuates Apoptosis and Differentially Regulates TLR4 and TLR7 Gene Expression after Ischemia in the Preterm Ovine Fetal Brain

Dhillon

Gunn

Jung³

et al. 2015

Dev Neurosci

View full text Add to dashboard Cite

show abstract

“…Increased systemic cytokines in premature infants with chorioamnionitis are associated with hemodynamic disturbances leading to cerebral hypoxia/ischemia, whereas co-morbid chorioamnionitis and placental perfusion defect put preterm infants at higher risk of abnormal neurologic outcomes than either insult alone [7,8,9]. Similarly, animal studies have demonstrated systemic inflammation induced by lipopolysaccharide sensitizes hypoxic/ischemic injury in the immature brain [10]. Preterm infants experience various hypoxic/ischemic and infectious insults from the perinatal to neonatal period.…”

Section: Introductionmentioning

confidence: 99%

Hypoxic/Ischemic and Infectious Events Have Cumulative Effects on the Risk of Cerebral Palsy in Very-Low-Birth-Weight Preterm Infants

Wang

Lin²,

Wang³

et al. 2014

Neonatology

View full text Add to dashboard Cite

Background: Hypoxia/ischemia and inflammation are two major mechanisms for cerebral palsy (CP) in preterm infants. Objective: To investigate whether hypoxia/ischemia- and infection-related events in the perinatal and neonatal periods had cumulative effects on CP risk in very-low-birth-weight (VLBW) premature infants. Methods: From 1995 to 2005, 5,807 VLBW preterm infants admitted to Taiwan hospitals were enrolled.The cumulative effects of hypoxic/ischemic and infectious events during the perinatal and neonatal periods on CP risk at corrected age 24 months were analyzed. Results: Of the 4,355 infants with 24-month follow-up, 457 (10.5%) had CP. The CP group had significantly higher incidences of hypoxia/ischemia-related events in the perinatal and neonatal periods, and sepsis in the neonatal period than the normal group. Three hypoxic/ischemic events, including birth cardiopulmonary resuscitation (OR 2.25; 95% CI 1.81-2.82), patent ductus arteriosus (PDA) ligation (2.94; 1.35-5.75) and chronic lung disease (3.14; 2.61-3.85) had the most significant contribution to CP. Relative to CP risk for infants with neither the three hypoxic/ischemic events nor sepsis, the CP odds increased 1.98-, 2.26- and 2.15-fold for infants with birth cardiopulmonary resuscitation, PDA ligation and chronic lung disease, respectively; while the combination with sepsis further increased the odds to 3.18-, 3.83- and 3.25-fold, respectively. Using the three hypoxic/ischemic events plus sepsis, CP rates were 10.0, 16.7, 26.7, 40.0 and 54.7% for infants with none, one, two, three and four events, respectively. Conclusions: Hypoxic/ischemic and infectious events across the perinatal and neonatal periods exerted cumulative effects on CP risk in VLBW premature infants.

show abstract

“…Microglial activation has a central role in this process via excitotoxic, inflammatory, and free radical injury to the developing central nervous system (44). The aforementioned hypothesis has been further validated in rat models of the generation of neuroinflammation in which rat pups subjected to both endotoxin and hypoxic ischemia demonstrated white water injury but sham and endotoxin alone groups did not (45). The group that received both endotoxin and hypoxic ischemia notably had an increase in activated microglia and tumor necrosis factor (TNF)-alpha expression compared to the other groups.…”

Section: Early-life Exposuresmentioning

confidence: 97%

Impact of Early-Life Exposures to Infections, Antibiotics, and Vaccines on Perinatal and Long-term Health and Disease

et al. 2017

View full text Add to dashboard Cite

Essentially, all neonates are exposed to infections, antibiotics, or vaccines early in their lives. This is especially true for those neonates born underweight or premature. In contrast to septic adults and children who are at an increased risk for subsequent infections, exposure to infection during the neonatal period is not associated with an increased risk of subsequent infection and may be paradoxically associated with reductions in late-onset sepsis (LOS) in the most premature infants. Perinatal inflammation is also associated with a decreased incidence of asthma and atopy later in life. Conversely, septic neonates are at increased risk of impaired long-term neurodevelopment. While the positive effects of antibiotics in the setting of infection are irrefutable, prolonged administration of broad-spectrum, empiric antibiotics in neonates without documented infection is associated with increased risk of LOS, necrotizing enterocolitis, or death. Vaccines provide a unique opportunity to prevent infection-associated disease; unfortunately, vaccinations have been largely unsuccessful when administered in the first month of life with the exception of vaccines against hepatitis B and tuberculosis. Future vaccines will require the use of novel adjuvants to overcome this challenge. This review describes the influence of infections, antibiotics, and vaccines during the first days of life, as well as the influence on future health and disease. We will also discuss potential immunomodulating therapies, which may serve to train the preterm immune system and reduce subsequent infectious burden without subjecting neonates to the risks accompanied by virulent pathogens.

show abstract

76 Efficacy of a Feeding Guideline Based Upon Gastric Emptying

Cited by 5 publications

References 0 publications

Lipopolysaccharide-Induced Preconditioning Attenuates Apoptosis and Differentially Regulates TLR4 and TLR7 Gene Expression after Ischemia in the Preterm Ovine Fetal Brain

Lipopolysaccharide-Induced Preconditioning Attenuates Apoptosis and Differentially Regulates TLR4 and TLR7 Gene Expression after Ischemia in the Preterm Ovine Fetal Brain

Hypoxic/Ischemic and Infectious Events Have Cumulative Effects on the Risk of Cerebral Palsy in Very-Low-Birth-Weight Preterm Infants

Impact of Early-Life Exposures to Infections, Antibiotics, and Vaccines on Perinatal and Long-term Health and Disease

Contact Info

Product

Resources

About