Preterm Brain Injury, Antenatal Triggers, and Therapeutics: Timing Is Key
With a worldwide incidence of 15 million cases, preterm birth is a major contributor to neonatal mortality and morbidity, and concomitant social and economic burden Preterm infants are predisposed to life-long neurological disorders due to the immaturity of the brain. The risks are inversely proport...
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| Format: | Article |
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MDPI AG
2020-08-01
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| Series: | Cells |
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| Online Access: | https://www.mdpi.com/2073-4409/9/8/1871 |
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| author | Daan R.M.G. Ophelders Ruth Gussenhoven Luise Klein Reint K. Jellema Rob J.J. Westerlaken Matthias C. Hütten Jeroen Vermeulen Guido Wassink Alistair J. Gunn Tim G.A.M. Wolfs |
| author_facet | Daan R.M.G. Ophelders Ruth Gussenhoven Luise Klein Reint K. Jellema Rob J.J. Westerlaken Matthias C. Hütten Jeroen Vermeulen Guido Wassink Alistair J. Gunn Tim G.A.M. Wolfs |
| author_sort | Daan R.M.G. Ophelders |
| collection | DOAJ |
| description | With a worldwide incidence of 15 million cases, preterm birth is a major contributor to neonatal mortality and morbidity, and concomitant social and economic burden Preterm infants are predisposed to life-long neurological disorders due to the immaturity of the brain. The risks are inversely proportional to maturity at birth. In the majority of extremely preterm infants (<28 weeks’ gestation), perinatal brain injury is associated with exposure to multiple inflammatory perinatal triggers that include antenatal infection (i.e., chorioamnionitis), hypoxia-ischemia, and various postnatal injurious triggers (i.e., oxidative stress, sepsis, mechanical ventilation, hemodynamic instability). These perinatal insults cause a self-perpetuating cascade of peripheral and cerebral inflammation that plays a critical role in the etiology of diffuse white and grey matter injuries that underlies a spectrum of connectivity deficits in survivors from extremely preterm birth. This review focuses on chorioamnionitis and hypoxia-ischemia, which are two important antenatal risk factors for preterm brain injury, and highlights the latest insights on its pathophysiology, potential treatment, and future perspectives to narrow the translational gap between preclinical research and clinical applications. |
| first_indexed | 2024-03-10T17:41:06Z |
| format | Article |
| id | doaj.art-bb35dfa2bba94f72963d37b4664da72a |
| institution | Directory Open Access Journal |
| issn | 2073-4409 |
| language | English |
| last_indexed | 2024-03-10T17:41:06Z |
| publishDate | 2020-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cells |
| spelling | doaj.art-bb35dfa2bba94f72963d37b4664da72a2023-11-20T09:43:02ZengMDPI AGCells2073-44092020-08-0198187110.3390/cells9081871Preterm Brain Injury, Antenatal Triggers, and Therapeutics: Timing Is KeyDaan R.M.G. Ophelders0Ruth Gussenhoven1Luise Klein2Reint K. Jellema3Rob J.J. Westerlaken4Matthias C. Hütten5Jeroen Vermeulen6Guido Wassink7Alistair J. Gunn8Tim G.A.M. Wolfs9Department of Pediatrics, Maastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsDepartment of Pediatrics, Maastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsDepartment of Pediatrics, Maastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsDepartment of Pediatrics, Maastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsDepartment of Pediatrics, Maastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsDepartment of Pediatrics, Maastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsDepartment of Pediatric Neurology, Maastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsDepartment of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Private bag 92019, Auckland 1023, New ZealandDepartment of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Private bag 92019, Auckland 1023, New ZealandDepartment of Pediatrics, Maastricht University Medical Center, 6202 AZ Maastricht, The NetherlandsWith a worldwide incidence of 15 million cases, preterm birth is a major contributor to neonatal mortality and morbidity, and concomitant social and economic burden Preterm infants are predisposed to life-long neurological disorders due to the immaturity of the brain. The risks are inversely proportional to maturity at birth. In the majority of extremely preterm infants (<28 weeks’ gestation), perinatal brain injury is associated with exposure to multiple inflammatory perinatal triggers that include antenatal infection (i.e., chorioamnionitis), hypoxia-ischemia, and various postnatal injurious triggers (i.e., oxidative stress, sepsis, mechanical ventilation, hemodynamic instability). These perinatal insults cause a self-perpetuating cascade of peripheral and cerebral inflammation that plays a critical role in the etiology of diffuse white and grey matter injuries that underlies a spectrum of connectivity deficits in survivors from extremely preterm birth. This review focuses on chorioamnionitis and hypoxia-ischemia, which are two important antenatal risk factors for preterm brain injury, and highlights the latest insights on its pathophysiology, potential treatment, and future perspectives to narrow the translational gap between preclinical research and clinical applications.https://www.mdpi.com/2073-4409/9/8/1871preterm brain injuryhypoxia-ischemiachorioamnionitistimingtherapeutic hypothermiastem cells |
| spellingShingle | Daan R.M.G. Ophelders Ruth Gussenhoven Luise Klein Reint K. Jellema Rob J.J. Westerlaken Matthias C. Hütten Jeroen Vermeulen Guido Wassink Alistair J. Gunn Tim G.A.M. Wolfs Preterm Brain Injury, Antenatal Triggers, and Therapeutics: Timing Is Key Cells preterm brain injury hypoxia-ischemia chorioamnionitis timing therapeutic hypothermia stem cells |
| title | Preterm Brain Injury, Antenatal Triggers, and Therapeutics: Timing Is Key |
| title_full | Preterm Brain Injury, Antenatal Triggers, and Therapeutics: Timing Is Key |
| title_fullStr | Preterm Brain Injury, Antenatal Triggers, and Therapeutics: Timing Is Key |
| title_full_unstemmed | Preterm Brain Injury, Antenatal Triggers, and Therapeutics: Timing Is Key |
| title_short | Preterm Brain Injury, Antenatal Triggers, and Therapeutics: Timing Is Key |
| title_sort | preterm brain injury antenatal triggers and therapeutics timing is key |
| topic | preterm brain injury hypoxia-ischemia chorioamnionitis timing therapeutic hypothermia stem cells |
| url | https://www.mdpi.com/2073-4409/9/8/1871 |
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