지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2013.1
- 수록면
- 333 - 340 (8page)
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초록· 키워드
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Despite marked improvements in perinatal practice, neonatal hypoxic-ischemic encephalopathy (HIE) remains one of the major causes of acute mortality and chronic neurologic disability in infants and children. Several new therapeutic approaches aiming at this condition have been used in the last decade, including therapeutic hypothermia and many pharmacological agents. Therapeutic hypothermia remarkably reduces death and neurological impairment, and has therefore rapidly become the standard therapy for full-term newborn infants with moderate-to-severe HIE. However, despite these promising outcomes of therapeutic hypothermia, approximately 50% of the infants treated with hypothermia have an adverse outcome. Therefore, there exists an urgent need for other treatment options. A mechanistically driven approach to HIE has resulted in the development of many drugs that are potent antagonists of specific steps in cascades of molecular reactions in HI injury. This review provides an overview of promising pharmacological approaches of neuroprotection that may be used in clinical practice. Although several drugs have been found to be effective in preclinical evaluations, such antagonists have been ineffective in human trials.
Failure has been attributed to many factors such as the complex pathology of HIE in neonates, the inevitable delays in initiation of therapy in clinical practice, and the side effects of the drugs. Moreover, many of these drugs interfere with only one step of the cascades, while multiple biochemical cascades are put in motion simultaneously. Therefore, neuroprotective strategies such as hypothermia have to deal with multiple cascades. Research is now being focused on drugs that may act synergistically or additively with hypothermia, with the hope that combination therapy might augment neuroprotection.
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참고문헌 (25)
참고문헌 신청
Aly H / 2009 / Ascorbic acid combined with ibuprofen in hypoxic ischemic encephalopathy: a randomized controlled trial / J Perinatol 29 : 438 ~ 443
Chakkarapani E / 2010 / Xenon enhances hypothermic neuroprotection in asphyxiated newborn pigs / Ann Neurol 68 : 330 ~ 341
Cilio MR / 2010 / Synergistic neuroprotective therapies with hypothermia / Semin Fetal Neonatal Med 15 : 293 ~ 298
Faulkner S / 2011 / Xenon augmented hypothermia reduces early lactate/N-acetylaspartate and cell death in perinatal asphyxia / Ann Neurol 70 : 133 ~ 150
Filippi L / 2012 / Safety and efficacy of topiramate in neonates with hypoxic ischemic encephalopathy treated with hypothermia (NeoNATI) / BMC Pediatr 12 : 144 ~
Chakkarapani E / 2010 / Xenon enhances hypothermic neuroprotection in asphyxiated newborn pigs / Ann Neurol 68 : 330 ~ 341
Cilio MR / 2010 / Synergistic neuroprotective therapies with hypothermia / Semin Fetal Neonatal Med 15 : 293 ~ 298
Faulkner S / 2011 / Xenon augmented hypothermia reduces early lactate/N-acetylaspartate and cell death in perinatal asphyxia / Ann Neurol 70 : 133 ~ 150
Filippi L / 2012 / Safety and efficacy of topiramate in neonates with hypoxic ischemic encephalopathy treated with hypothermia (NeoNATI) / BMC Pediatr 12 : 144 ~
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