Preserving Brain Function During Neonatal Asphyxia

Tan, Sidhartha; Parks, Dale A.

doi:10.1016/s0095-5108(18)30048-4

Cited by 17 publications

(9 citation statements)

References 70 publications

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“…Many studies of cytokines in seizure are still ongoing, and new hypotheses about their roles are being formed. Until now, reactive species were only thought to cause harm if the antioxidant defenses were overwhelmed; however, a new interesting idea has been proposed, that the interaction between reactive species and antioxidant defenses ultimately causes cellular injury and death27).…”

Section: Discussionmentioning

confidence: 99%

The role of cytokines in seizures: interleukin (IL)-1β, IL-1Ra, IL-8, and IL-10

2013

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Brain insults, including neurotrauma, infection, and perinatal injuries such as hypoxic ischemic encephalopathy, generate inflammation in the brain. These inflammatory cascades induce a wide spectrum of cytokines, which can cause neuron degeneration, have neurotoxic effects on brain tissue, and lead to the development of seizures, even if they are subclinical and occur at birth. Cytokines are secreted by the glial cells of the central nervous system and they function as immune system mediators. Cytokines can be proinflammatory or anti-inflammatory. Interleukin (IL)-1β and IL-8 are proinflammatory cytokines that activate additional cytokine cascades and increase seizure susceptibility and organ damage, whereas IL-1 receptor antagonist and IL-10 act as anti-inflammatory cytokines that have protective and anticonvulsant effects. Therefore, the immune system and its associated inflammatory reactions appear to play an important role in brain damage. Whether cytokine release is relevant for the processes of epileptogenesis and antiepileptogenesis, and whether epileptogenesis could be prevented by immunomodulatory treatment should be addressed in future clinical studies. Furthermore, early detection of brain damage and early intervention are essential for the prevention of disease progression and further neurological complications. Therefore, cytokines might be useful as biomarkers for earlier detection of brain damage in high-risk infants.

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Section: Discussionmentioning

confidence: 99%

The role of cytokines in seizures: interleukin (IL)-1β, IL-1Ra, IL-8, and IL-10

2013

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“…While the latter prevents the destructive actions of free radicals, the former acts as a neuromodulator, preventing the activation of NMDA by neurotransmitters. 8 Lately, cerebral cooling or selective cerebral hypothermia was found to be neuroprotective. 18 It reduces oxygen consumption, metabolic rate, the accumulation of excitatory amino acids, nitric oxide synthase activity production of cytotoxic cytokines and delayed cell death by apoptosis.…”

Section: Managementmentioning

confidence: 99%

Management Options In Neonatal Encephalopathy

Ogundeyi¹,

Ogunlesi²

2009

IJPN

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Neonatal encephalopathy is important for its association with significant morbidity and mortality in the newborn period as well as chronic handicapping conditions later in life. It most commonly occurs following perinatal asphyxia and causes significant brain damage. Although, it is characterized by specific clinical and neuroimaging features, the management of the condition is largely supportive. Recent advances in the pathophysiology of neonatal encephalopathy include the role of increased cytosolic influx of calcium ions, excitatory amino acid neurotransmitters and mediators of inflammation like nitric oxide and free radicals in the disruption of neuronal metabolism thus, resulting in widespread neuronal deaths. The role and clinical applicability of these pathophysiological proposals in selecting management options for neonatal encephalopathy are discussed.

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“…Finally, allopurinol, a xanthine oxidase inhibitor and thus antioxidant, has been used in hypoxic ischemic human neonates. 51 There are anecdotal reports of its use in equine neonates with HEI and in adult horses suffering from brain injury after head trauma; however its clinical efficiency is also unknown. 45,52,53 …”

Section: Ancillary Therapymentioning

confidence: 99%