Sammendrag
Birth asphyxia can lead to hypoxic-ischaemic (HI) brain injury. A concomitant perinatal infection increases the risk of neurological sequelae. Hypothermia treatment (HT) is current standard treatment for birth asphyxia. 40-50% of patients still end up with permanent brain injury. In low-resource settings with high infection rates HT after birth asphyxia did not improve outcome. A neonatal rat model with lipopolysaccharide (LPS)-induced inflammation prior to HI injury negated HT effect. It has been hypothesised that infection prior to HI interfere with the neuroprotective potential of HT. However, infection demographics vary across the world, and LPS only represents gram-negative infections. In our part of the world >90% of term neonatal infections are caused by gram-positive bacteria. We modelled a gram-positive infection prior to an HI insult in a neonatal rat model. Their brains were more vulnerable, and HI brain injury was significantly increased. Still, HT was highly neuroprotective and reduced injury by 80%. This supports that HT should still be offered routinely to asphyxiated infants, at least in high-income countries where gram-negative infections are relatively rare.
Artikkelliste
Article I: Hypothermic Neuronal Rescue from Infection-sensitised Hypoxic-Ischaemic Brain Injury is Pathogen Dependent. Falck M., Osredkar D., Maes E., Flatebø T., Wood T., Sabir H., Thoresen M. Develomental Neuroscience, 2017. DOI: 10.1159/000455838. The paper is not available in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1159/000455838 |
Article II: Neonatal Systemic Inflammation Induce Inflammatory Reactions and Brain Apoptosis in a Pathogen Specific Manner. Falck M., Osredkar D., Maes E., Flatebø T., Wood T., Sabir H., Thoresen M. Neonatology, 2017. DOI: 10.1159/000481980. The paper is not available in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1159/000481980 |
Article III: Therapeutic Hypothermia is Neuroprotective after Severe Hypoxic-Ischaemic Brain injury in neonatal rats pre-exposed to PAM3CSK4. Falck M., Osredkar D., Maes E., Flatebø T., Wood T., Sabir H., Thoresen M. Developmental Neuroscience, 2018. DOI: 10.1159/000487798. The paper is not available in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1159/000487798 |