Perinatal Hypoxic-Ischemic Brain Injury: Detection & Intervention. An experimental study in newborn piglets

Abstract

Hypoxic-ischemic insults in the perinatal period rank globally among the three leading causes of newborn mortality. Many of the newborns that survive the initial insult are developing disordered brain function known as hypoxic-ischemic encephalopathy (HIE). Those with moderate to severe HIE have a high risk of lifelong neurodisability with severe psychosocial and socioeconomic consequences for the child, the families involved and for society in general. Currently, the only available treatment to minimize the consequences of HIE is therapeutic hypothermia. However, despite cooling the risk of death or severe neurodisability is still high and additional neuroprotective strategies are greatly needed. Further, determining the exact etiology and the timing of brain injury is often challenging and might preclude optimal treatment. Identifying novel biomarkers that could provide reliable information about the timing and nature of brain injury could potentially improve treatment and outcome for these newborns. In this thesis, we have used a well-established piglet model of perinatal hypoxia-ischemia to explore the effects of a promising neuroprotectant, cannabidiol, as well as the potential of circulating microRNAs to be markers of hypoxic-ischemic injury.