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Does Perinatal Intermittent Hypoxia Affect Cerebrovascular Network Development? 围产期间歇性缺氧会影响脑血管网络发育吗?
IF 2.9 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2024-01-01 Epub Date: 2023-05-09 DOI: 10.1159/000530957
Vanessa Coelho-Santos, Anne-Jolene N Cruz, Andy Y Shih

Perinatal hypoxia is an inadequate delivery of oxygen to the fetus in the period immediately before, during, or after the birth process. The most frequent form of hypoxia occurring in human development is chronic intermittent hypoxia (CIH) due to sleep-disordered breathing (apnea) or bradycardia events. CIH incidence is particularly high with premature infants. During CIH, repetitive cycles of hypoxia and reoxygenation initiate oxidative stress and inflammatory cascades in the brain. A dense microvascular network of arterioles, capillaries, and venules is required to support the constant metabolic demands of the adult brain. The development and refinement of this microvasculature is orchestrated throughout gestation and in the initial weeks after birth, at a critical juncture when CIH can occur. There is little knowledge on how CIH affects the development of the cerebrovasculature. However, since CIH (and its treatments) can cause profound abnormalities in tissue oxygen content and neural activity, there is reason to believe that it can induce lasting abnormalities in vascular structure and function at the microvascular level contributing to neurodevelopmental disorders. This mini-review discusses the hypothesis that CIH induces a positive feedback loop to perpetuate metabolic insufficiency through derailment of normal cerebrovascular development, leading to long-term deficiencies in cerebrovascular function.

围产期缺氧是指在胎儿出生前、出生过程中或出生后向胎儿提供的氧气不足。人类发育过程中最常见的缺氧形式是睡眠呼吸紊乱(呼吸暂停)或心动过缓导致的慢性间歇性缺氧(CIH)。早产儿的 CIH 发生率尤其高。在 CIH 期间,反复循环的缺氧和复氧会在大脑中引发氧化应激和炎症级联反应。成人大脑需要一个由动脉血管、毛细血管和静脉组成的密集微血管网络来支持持续的新陈代谢需求。这种微血管的发育和完善贯穿整个妊娠期和出生后最初几周,而这正是可能发生 CIH 的关键时刻。关于 CIH 如何影响脑血管的发育,目前所知甚少。然而,由于 CIH(及其治疗方法)可导致组织氧含量和神经活动的严重异常,因此有理由相信它可在微血管水平上诱发血管结构和功能的持久异常,从而导致神经发育障碍。这篇微型综述讨论的假设是,CIH 通过破坏正常的脑血管发育,诱发正反馈循环,使代谢不足永久化,从而导致脑血管功能的长期缺陷。
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引用次数: 0
Fluoxetine Can Cause Epileptogenesis and Aberrant Neurogenesis in Male Wild-Type Mice. 氟西汀会导致雄性野生型小鼠癫痫发生和神经发生异常
IF 2.9 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2024-01-01 Epub Date: 2023-06-09 DOI: 10.1159/000531478
Ksenia Musaelyan, Mark A Horowitz, Stephen McHugh, Francis G Szele

Antidepressants in general, and fluoxetine in particular, increase adult hippocampal neurogenesis (AHN) in mice. Here we asked how the antidepressant fluoxetine affects behavior and AHN in a corticosterone model of depression. In three groups of adult male C57BL/6j mice, we administered either vehicle (VEH), corticosterone (CORT) treatment to induce a depression-like state, or corticosterone plus a standard dose of fluoxetine (CORT+FLX). Following treatment, mice performed the open field test, the novelty suppressed feeding (NSF) test, and the splash test. Neurogenesis was assessed by means of immunohistochemistry using BrdU and neuronal maturation markers. Unexpectedly, 42% of the CORT+FLX-treated mice exhibited severe weight loss, seizures, and sudden death. As expected, the CORT-treated group had altered behaviors compared to the VEH group, but the CORT+FLX mice that survived did not show any behavioral improvement compared to the CORT group. Antidepressants generally increase neurogenesis and here we also found that compared to CORT mice, CORT+FLX mice that survived had a significantly greater density of BrdU+, BrdU+DCX+, and BrdU+NeuN+ cells, suggesting increased neurogenesis. Moreover, the density of BrdU+NeuN+ cells was increased in an aberrant location, the hilus, of CORT+FLX mice, similar to previous studies describing aberrant neurogenesis following seizures. In conclusion, fluoxetine could induce considerable adverse effects in wild-type mice, including seizure-like activity. Fluoxetine-induced neurogenesis increases could be related to this activity; therefore, proneurogenic effects of fluoxetine and other antidepressants, especially in the absence of any behavioral therapeutic effects, should be interpreted with caution.

抗抑郁药尤其是氟西汀能增加小鼠成年海马神经发生(AHN)。在此,我们探讨了抗抑郁药氟西汀如何在皮质酮抑郁模型中影响行为和AHN。在三组成年雄性 C57BL/6j 小鼠中,我们分别给予药物(VEH)、皮质酮(CORT)治疗以诱导抑郁样状态,或皮质酮加标准剂量的氟西汀(CORT+FLX)。治疗后,小鼠进行了开阔地试验、新奇抑制摄食(NSF)试验和飞溅试验。通过使用 BrdU 和神经元成熟标记物的免疫组化方法对神经发生进行了评估。出乎意料的是,42% 经 CORT+FLX 处理的小鼠表现出严重的体重减轻、癫痫发作和猝死。不出所料,与 VEH 组相比,CORT 治疗组小鼠的行为发生了改变,但与 CORT 组相比,存活下来的 CORT+FLX 小鼠没有表现出任何行为改善。抗抑郁药通常会增加神经发生,在这里我们还发现,与 CORT 小鼠相比,存活下来的 CORT+FLX 小鼠的 BrdU+、BrdU+DCX+ 和 BrdU+NeuN+ 细胞密度显著增加,表明神经发生增加。此外,BrdU+NeuN+细胞的密度在CORT+FLX小鼠的一个异常位置(脊髓)有所增加,这与之前描述癫痫发作后异常神经发生的研究相似。总之,氟西汀会对野生型小鼠产生相当大的不良影响,包括癫痫发作样活动。氟西汀诱导的神经发生增加可能与这种活动有关;因此,应谨慎解释氟西汀和其他抗抑郁药的神经发生效应,尤其是在没有任何行为治疗效应的情况下。
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引用次数: 0
Ultrasound-Induced Prenatal Stress: New Possibilities for Modeling Mental Disorders. 超声诱导的产前应激:模拟精神障碍的新可能性。
IF 2.3 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2024-01-01 Epub Date: 2023-10-19 DOI: 10.1159/000534687
Olga Abramova, Anna Morozova, Eugene Zubkov, Valeria Ushakova, Yana Zorkina, Andrey T Proshin, Zinaida Storozheva, Olga Gurina, Vladimir Chekhonin

The development of animal models of mental disorders is an important task since such models are useful for studying the neurobiological mechanisms of psychopathologies and for trial of new therapeutic drugs. One way to model pathologies of the nervous system is to impair fetal neurodevelopment through stress of the pregnant future mother, or prenatal stress (PS). The use of variable frequency ultrasound (US) in rodents is a promising method of imitating psychological stress, to which women in modern society are most often subjected. The aim of our study was to investigate the effect of PS induced by exposure to variable frequency ultrasound (US PS) throughout the gestational period on the adult rat offspring, namely, to identify features of behavioral alterations and neurochemical brain parameters that can be associated with certain mental disorders in humans, to determine the possibility of creating a new model of psychopathology. Our study included a study of some behavioral characteristics of male and female rats in the elevated plus maze, open-field test, object recognition test, social interaction test, sucrose preference test, latent inhibition test, Morris water maze, forced swimming test, acoustic startle reflex, and prepulse inhibition tests. We also determined the activity of the serotonergic, dopaminergic, and noradrenergic neurotransmitter systems in the hippocampus and frontal cortex by HPLC-ED. Concentration of norepinephrine, dopamine, DOPAC, serotonin, and HIAA, as well as DOPAC/dopamine and HIAA/serotonin ratios were determined. A correlation analysis of behavioral and neurochemical parameters in male and female rats was performed based on the data obtained. The results of the study showed that US PS altered the behavioral phenotype of the rat offspring. US PS increased the level of anxious behavior, impaired orientation-research behavior, increased grooming activity, decreased the desire for social contacts, shifted behavioral reactions from social interaction to interaction with inanimate objects, impaired latent inhibition, and decreased the startle reflex. US PS activated the serotonergic, dopaminergic, and noradrenergic neurotransmitter systems of the rat frontal cortex and hippocampus. A correlation between neurochemical and behavioral parameters was revealed. Our study showed that US PS leads to a certain dysfunction on behavioral and neurochemical levels in rats that is most closely associated with symptoms of schizophrenia or autism. We hypothesize that this could potentially be an indicator of face validity for a model of psychopathology based on neurodevelopmental impairment.

开发精神障碍动物模型是一项重要任务,因为这些模型有助于研究精神病理学的神经生物学机制和新治疗药物的试验。模拟神经系统病理的一种方法是通过怀孕的未来母亲的压力或产前压力来损害胎儿的神经发育。在啮齿类动物身上使用变频超声波是一种很有前途的模拟心理压力的方法,而现代社会中女性最常受到这种压力的影响。我们研究的目的是研究在整个妊娠期暴露于变频超声(US PS)引起的产前压力对成年大鼠后代的影响,即确定可能与人类某些精神障碍相关的行为改变和神经化学大脑参数的特征,以确定创建一个新的精神病理学模型的可能性。我们的研究包括对雄性和雌性大鼠在高架+迷宫中的一些行为特征的研究、开阔场地测试、物体识别测试、社交互动测试、蔗糖偏好测试、潜在抑制测试、Morris水迷宫、强迫游泳测试、声惊反射和脉冲前抑制测试。我们还通过HPLC-ED测定了海马和额叶皮层中5-羟色胺能、多巴胺能和去甲肾上腺素能神经递质系统的活性。测定去甲肾上腺素、多巴胺、DOPAC、5-羟色胺和HIAA的浓度,以及DOPAC/多巴胺和HIAA/5-羟色胺的比率。根据获得的数据对雄性和雌性大鼠的行为和神经化学参数进行了相关性分析。研究结果表明,US PS改变了大鼠后代的行为表型。US PS增加了焦虑行为的水平,削弱了定向研究行为,增加了梳理活动,降低了社交接触的欲望,将行为反应从社交转变为与无生命物体的互动,削弱了潜在的抑制,并降低了惊吓反射。US PS激活大鼠额叶皮层和海马的5-羟色胺能、多巴胺能和去甲肾上腺素能神经递质系统。神经化学参数和行为参数之间存在相关性。我们的研究表明,US PS会导致大鼠的行为和神经化学水平出现一定的功能障碍,这与精神分裂症或自闭症的症状最为密切。我们假设这可能是基于神经发育障碍的精神病理学模型的面部有效性的一个指标。
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引用次数: 0
Pain/Stress, Mitochondrial Dysfunction, and Neurodevelopment in Preterm Infants. 早产儿的疼痛/压力、线粒体功能障碍和神经发育。
IF 2.3 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2024-01-01 Epub Date: 2024-01-29 DOI: 10.1159/000536509
Tingting Zhao, Xiaolin Chang, Subrata Kumar Biswas, Jeremy L Balsbaugh, Jennifer Liddle, Ming-Hui Chen, Adam P Matson, Nathan N Alder, Xiaomei Cong

Introduction: Preterm infants experience tremendous early life pain/stress during their neonatal intensive care unit (NICU) hospitalization, which impacts their neurodevelopmental outcomes. Mitochondrial function/dysfunction may interface between perinatal stress events and neurodevelopment. Nevertheless, the specific proteins or pathways linking mitochondrial functions to pain-induced neurodevelopmental outcomes in infants remain unidentified. Our study aims to investigate the associations among pain/stress, proteins associated with mitochondrial function/dysfunction, and neurobehavioral responses in preterm infants.

Methods: We conducted a prospective cohort study, enrolling 33 preterm infants between September 2017 and July 2022 at two affiliated NICUs located in Hartford and Farmington, CT. NICU Network Neurobehavioral Scale (NNNS) datasets were evaluated to explore potential association with neurobehavioral outcomes. The daily pain/stress experienced by infant's during their NICU stay was documented. At 36-38 weeks post-menstrual age (PMA), neurobehavioral outcomes were evaluated using the NNNS and buccal swabs were collected for further analysis. Mass spectrometry-based proteomics was conducted on epithelial cells obtained from buccal swabs to evaluate protein expression level. Lasso statistical methods were conducted to study the association between protein abundance and infants' NNNS summary scores. Multiple linear regression and Gene Ontology (GO) enrichment analyses were performed to examine how clinical characteristics and neurodevelopmental outcomes may be associated with protein levels and underlying molecular pathways.

Results: During NICU hospitalization, preterm premature rupture of membrane (PPROM) was negatively associated with neurobehavioral outcomes. The protein functions including leptin receptor binding activity, glutathione disulfide oxidoreductase activity and response to oxidative stress, lipid metabolism, and phosphate and proton transmembrane transporter activity were negatively associated with neurobehavioral outcomes; in contrast, cytoskeletal regulation, epithelial barrier, and protection function were found to be associated with the optimal neurodevelopmental outcomes. In addition, mitochondrial function-associated proteins including SPRR2A, PAIP1, S100A3, MT-CO2, PiC, GLRX, PHB2, and BNIPL-2 demonstrated positive association with favorable neurodevelopmental outcomes, while proteins of ABLIM1, UNC45A, keratins, MUC1, and CYB5B showed positive association with adverse neurodevelopmental outcomes.

Conclusion: Mitochondrial function-related proteins were observed to be associated with early life pain/stress and neurodevelopmental outcomes in infants. Large-scale studies with longitudinal datasets are warranted. Buccal proteins could be used to predict potential neurobehavioral outcomes.

导言 早产儿在新生儿重症监护室(NICU)住院期间会经历巨大的早期疼痛/压力,这影响了他们的神经发育结果。线粒体功能/功能障碍可能是围产期应激事件与神经发育之间的联系。然而,将线粒体功能与疼痛引起的婴儿神经发育结果联系起来的特定蛋白质或途径仍未确定。我们的研究旨在探讨早产儿疼痛/压力、与线粒体功能/功能障碍相关的蛋白质和神经行为反应之间的关联。方法 我们进行了一项前瞻性队列研究,在 2017 年 9 月至 2022 年 7 月期间,在位于康涅狄格州哈特福德和法明顿的两家附属新生儿重症监护室招募了 33 名早产儿。对新生儿重症监护室网络神经行为量表(NNNS)数据集进行了评估,以探讨与神经行为结果的潜在关联。记录了婴儿在新生儿重症监护室住院期间每天所经历的疼痛/压力。在月龄后 36-38 周(PMA),使用 NNNS 对神经行为结果进行评估,并收集颊拭子进行进一步分析。对从颊拭子中获得的上皮细胞进行了基于质谱的蛋白质组学研究,以评估蛋白质表达水平。采用拉索统计方法研究蛋白质丰度与婴儿 NNNS 总分之间的关联。还进行了多元线性回归和基因本体(Gene Ontology,GO)富集分析,以研究临床特征和神经发育结果如何与蛋白质水平和潜在的分子通路相关联。结果 在新生儿重症监护病房住院期间,早产儿胎膜早破(PPROM)与神经行为结果呈负相关。瘦素受体结合活性、谷胱甘肽二硫氧化还原酶活性和对氧化应激的反应、脂质代谢、磷酸盐和质子跨膜转运体活性等蛋白质功能与神经行为结果呈负相关,而细胞骨架调节、上皮屏障和保护功能则与最佳神经发育结果相关。此外,线粒体功能相关蛋白包括 SPRR2A、PAIP1、S100A3、MT-CO2、PiC、GLRX、PHB2 和 BNIPL-2 与良好的神经发育结果呈正相关,而 ABLIM1、UNC45A、Keratins、MUC1 和 CYB5B 蛋白与不良的神经发育结果呈正相关。结论 观察到线粒体功能相关蛋白与婴儿早期疼痛/压力和神经发育结果有关。有必要对纵向数据集进行大规模研究。口腔蛋白质可用于预测潜在的神经行为结果。
{"title":"Pain/Stress, Mitochondrial Dysfunction, and Neurodevelopment in Preterm Infants.","authors":"Tingting Zhao, Xiaolin Chang, Subrata Kumar Biswas, Jeremy L Balsbaugh, Jennifer Liddle, Ming-Hui Chen, Adam P Matson, Nathan N Alder, Xiaomei Cong","doi":"10.1159/000536509","DOIUrl":"10.1159/000536509","url":null,"abstract":"<p><strong>Introduction: </strong>Preterm infants experience tremendous early life pain/stress during their neonatal intensive care unit (NICU) hospitalization, which impacts their neurodevelopmental outcomes. Mitochondrial function/dysfunction may interface between perinatal stress events and neurodevelopment. Nevertheless, the specific proteins or pathways linking mitochondrial functions to pain-induced neurodevelopmental outcomes in infants remain unidentified. Our study aims to investigate the associations among pain/stress, proteins associated with mitochondrial function/dysfunction, and neurobehavioral responses in preterm infants.</p><p><strong>Methods: </strong>We conducted a prospective cohort study, enrolling 33 preterm infants between September 2017 and July 2022 at two affiliated NICUs located in Hartford and Farmington, CT. NICU Network Neurobehavioral Scale (NNNS) datasets were evaluated to explore potential association with neurobehavioral outcomes. The daily pain/stress experienced by infant's during their NICU stay was documented. At 36-38 weeks post-menstrual age (PMA), neurobehavioral outcomes were evaluated using the NNNS and buccal swabs were collected for further analysis. Mass spectrometry-based proteomics was conducted on epithelial cells obtained from buccal swabs to evaluate protein expression level. Lasso statistical methods were conducted to study the association between protein abundance and infants' NNNS summary scores. Multiple linear regression and Gene Ontology (GO) enrichment analyses were performed to examine how clinical characteristics and neurodevelopmental outcomes may be associated with protein levels and underlying molecular pathways.</p><p><strong>Results: </strong>During NICU hospitalization, preterm premature rupture of membrane (PPROM) was negatively associated with neurobehavioral outcomes. The protein functions including leptin receptor binding activity, glutathione disulfide oxidoreductase activity and response to oxidative stress, lipid metabolism, and phosphate and proton transmembrane transporter activity were negatively associated with neurobehavioral outcomes; in contrast, cytoskeletal regulation, epithelial barrier, and protection function were found to be associated with the optimal neurodevelopmental outcomes. In addition, mitochondrial function-associated proteins including SPRR2A, PAIP1, S100A3, MT-CO2, PiC, GLRX, PHB2, and BNIPL-2 demonstrated positive association with favorable neurodevelopmental outcomes, while proteins of ABLIM1, UNC45A, keratins, MUC1, and CYB5B showed positive association with adverse neurodevelopmental outcomes.</p><p><strong>Conclusion: </strong>Mitochondrial function-related proteins were observed to be associated with early life pain/stress and neurodevelopmental outcomes in infants. Large-scale studies with longitudinal datasets are warranted. Buccal proteins could be used to predict potential neurobehavioral outcomes.</p>","PeriodicalId":50585,"journal":{"name":"Developmental Neuroscience","volume":" ","pages":"341-352"},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139577102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characterization of Gene Regulatory Elements in Human Fetal Cortical Development: Enhancing Our Understanding of Neurodevelopmental Disorders and Evolution. 人类胎儿皮层发育中基因调控元件的特征:加强我们对神经发育障碍和进化的理解。
IF 2.9 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2024-01-01 Epub Date: 2023-05-10 DOI: 10.1159/000530929
Qiuyu Guo, Sarah Wu, Daniel H Geschwind

The neocortex is the region that most distinguishes human brain from other mammals and primates [Annu Rev Genet. 2021 Nov;55(1):555-81]. Studying the development of human cortex is important in understanding the evolutionary changes occurring in humans relative to other primates, as well as in elucidating mechanisms underlying neurodevelopmental disorders. Cortical development is a highly regulated process, spatially and temporally coordinated by expression of essential transcriptional factors in response to signaling pathways [Neuron. 2019 Sep;103(6):980-1004]. Enhancers are the most well-understood cis-acting, non-protein-coding regulatory elements that regulate gene expression [Nat Rev Genet. 2014 Apr;15(4):272-86]. Importantly, given the conservation of both DNA sequence and molecular function of the majority of proteins across mammals [Genome Res. 2003 Dec;13(12):2507-18], enhancers [Science. 2015 Mar;347(6226):1155-9], which are far more divergent at the sequence level, likely account for the phenotypes that distinguish the human brain by changing the regulation of gene expression. In this review, we will revisit the conceptual framework of gene regulation during human brain development, as well as the evolution of technologies to study transcriptional regulation, with recent advances in genome biology that open a window allowing us to systematically characterize cis-regulatory elements in developing human brain [Hum Mol Genet. 2022 Oct;31(R1):R84-96]. We provide an update on work to characterize the suite of all enhancers in the developing human brain and the implications for understanding neuropsychiatric disorders. Finally, we discuss emerging therapeutic ideas that utilize our emerging knowledge of enhancer function.

新皮质是人类大脑区别于其他哺乳动物和灵长类动物最大的区域[Annu Rev Genet. 2021 Nov;55(1):555-81]。研究人类大脑皮层的发育对于了解人类相对于其他灵长类动物发生的进化变化以及阐明神经发育障碍的内在机制非常重要。大脑皮层的发育是一个高度调控的过程,通过基本转录因子的表达对信号通路做出响应,在空间和时间上进行协调 [Neuron. 2019 Sep;103(6):980-1004] 。增强子是最广为人知的顺式作用、非蛋白编码调控元件,可调控基因表达 [Nat Rev Genet. 2014 Apr; 15(4):272-86]。重要的是,鉴于哺乳动物中大多数蛋白质的 DNA 序列和分子功能都保持不变[Genome Res. 2003 Dec;13(12):2507-18],增强子[Science. 2015 Mar;347(6226):1155-9]在序列水平上的差异要大得多,但它们很可能通过改变基因表达的调控来解释人类大脑的表型特征。在这篇综述中,我们将重新审视人脑发育过程中基因调控的概念框架,以及转录调控研究技术的演变,基因组生物学的最新进展为我们打开了一扇窗,使我们能够系统地描述发育中人脑的顺式调控元件 [Hum Mol Genet. 2022 Oct;31(R1):R84-96] 。我们提供了有关表征发育中人脑中所有增强子的最新进展,以及对理解神经精神疾病的影响。最后,我们讨论了利用我们对增强子功能的新认识的新兴治疗理念。
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引用次数: 0
Brain Injury Outcomes after Adjuvant Erythropoietin Neuroprotection for Moderate or Severe Neonatal Hypoxic-Ischemic Encephalopathy: A Report from the HEAL Trial. 辅助促红细胞生成素神经保护治疗中度或重度新生儿缺氧缺血性脑病后的脑损伤结果:HEAL试验报告。
IF 2.3 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2024-01-01 Epub Date: 2023-10-31 DOI: 10.1159/000534618
Jessica L Wisnowski, Sarah E Monsell, Stefan Bluml, Amy M Goodman, Yi Li, Bryan A Comstock, Patrick J Heagerty, Sandra E Juul, Yvonne W Wu, Robert C McKinstry, Amit M Mathur

Introduction: Erythropoietin (Epo) is a putative neuroprotective therapy that did not improve overall outcomes in a phase 3 randomized controlled trial for neonates with moderate or severe hypoxic-ischemic encephalopathy (HIE). However, HIE is a heterogeneous disorder, and it remains to be determined whether Epo had beneficial effects on a subset of perinatal brain injuries.

Methods: This study was a secondary analysis of neuroimaging data from the High-dose Erythropoietin for Asphyxia and Encephalopathy (HEAL) Trial, which was conducted from 2016 to 2021 at 17 sites involving 23 US academic medical centers. Participants were neonates >36 weeks' gestation undergoing therapeutic hypothermia for moderate or severe HIE who received 5 doses of study drug (Epoetin alpha 1,000 U/kg/dose) or placebo in the first week of life. Treatment assignment was stratified by trial site and severity of encephalopathy. The primary outcome was the locus, pattern, and acuity of brain injury as determined by three independent readers using a validated HIE Magnetic Resonance Imaging (MRI) scoring system.

Results: Of the 500 infants enrolled in HEAL, 470 (94%) had high quality MRI data obtained at a median of 4.9 days of age (IQR: 4.5-5.8). The incidence of injury to the deep gray nuclei, cortex, white matter, brainstem and cerebellum was similar between Epo and placebo groups. Likewise, the distribution of injury patterns was similar between groups. Among infants imaged at less than 8 days (n = 414), 94 (23%) evidenced only acute, 93 (22%) only subacute and 89 (21%) both acute and subacute injuries, with similar distribution across treatment groups.

Conclusion: Adjuvant erythropoietin did not reduce the incidence of regional brain injury. Subacute brain injury was more common than previously reported, which has key implications for the development of adjuvant neuroprotective therapies for this population.

引言:在一项针对中度或重度缺氧缺血性脑病(HIE)新生儿的3期随机对照试验中,促红细胞生成素(Epo)是一种公认的神经保护疗法,但并未改善总体结果。然而,HIE是一种异质性疾病,Epo是否对围产期脑损伤有有益影响还有待确定。方法:本研究对2016年至2021年在涉及23个美国学术医疗中心的17个地点进行的高剂量促红细胞生成素治疗窒息和脑病(HEAL)试验的神经影像学数据进行了二次分析。参与者是妊娠期>36周的新生儿,因中度或重度HIE接受治疗性低温治疗,并在出生后第一周接受5剂研究药物(Epoetinα1000 U/kg/剂)或安慰剂。根据试验地点和脑病的严重程度对治疗分配进行分层。主要结果是由三名独立读者使用经验证的HIE磁共振成像(MRI)评分系统确定的脑损伤的部位、模式和敏锐度。结果:在参加HEAL的500名婴儿中,470名(94%)在中位4.9天时获得了高质量的MRI数据(IQR 4.5-5.8)。Epo组和安慰剂组的深灰色核、皮层、白质、脑干和小脑损伤发生率相似。同样,各组之间损伤模式的分布相似。在8天内成像的婴儿中(n=414),94(23%)只出现急性损伤,93(22%)只出现亚急性损伤,89(21%)同时出现急性和亚急性损伤。各治疗组的分布相似。结论:辅助红细胞生成素不能降低局部脑损伤的发生率。亚急性脑损伤比以前报道的更常见,这对开发该人群的辅助神经保护疗法具有关键意义。
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引用次数: 0
Blood Biomarkers in the Fetally Growth Restricted and Small for Gestational Age Neonate: Associations with Brain Injury. 胎儿生长受限和胎龄小新生儿的血液生物标志物:与脑损伤的关系
IF 2.9 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2024-01-01 Epub Date: 2023-05-10 DOI: 10.1159/000530492
Hannah Musco, Kate Beecher, Kirat K Chand, Paul B Colditz, Julie A Wixey

Fetal growth restriction (FGR) and small for gestational age (SGA) infants have increased risk of mortality and morbidity. Although both FGR and SGA infants have low birthweights for gestational age, a diagnosis of FGR also requires assessments of umbilical artery Doppler, physiological determinants, neonatal features of malnutrition, and in utero growth retardation. Both FGR and SGA are associated with adverse neurodevelopmental outcomes ranging from learning and behavioral difficulties to cerebral palsy. Up to 50% of FGR, newborns are not diagnosed until around the time of birth, yet this diagnosis lacks further indication of the risk of brain injury or adverse neurodevelopmental outcomes. Blood biomarkers may be a promising tool. Defining blood biomarkers indicating an infant's risk of brain injury would provide the opportunity for early detection and therefore earlier support. The aim of this review was to summarize the current literature to assist in guiding the future direction for the early detection of adverse brain outcomes in FGR and SGA neonates. The studies investigated potential diagnostic blood biomarkers from cord and neonatal blood or serum from FGR and SGA human neonates. Results were often conflicting with heterogeneity common in the biomarkers examined, timepoints, gestational age, and definitions of FGR and SGA used. Due to these variations, it was difficult to draw strong conclusions from the results. The search for blood biomarkers of brain injury in FGR and SGA neonates should continue as early detection and intervention is critical to improve outcomes for these neonates.

胎儿生长受限(FGR)和胎龄小(SGA)婴儿的死亡和发病风险都会增加。虽然 FGR 和 SGA 婴儿的出生体重都低于胎龄,但诊断 FGR 还需要评估脐动脉多普勒、生理决定因素、新生儿营养不良特征和子宫内生长迟缓。FGR 和 SGA 都与不良的神经发育结果有关,从学习和行为障碍到脑瘫不等。多达 50% 的 FGR 新生儿直到出生时才被确诊,但这一诊断并不能进一步说明脑损伤或不良神经发育结果的风险。血液生物标志物可能是一种很有前途的工具。确定表明婴儿脑损伤风险的血液生物标志物将为早期检测提供机会,从而尽早提供支持。本综述旨在总结目前的文献,以帮助指导未来早期检测FGR和SGA新生儿不良脑损伤的方向。这些研究调查了来自FGR和SGA新生儿的脐带血、新生儿血或血清中的潜在诊断性血液生物标志物。研究结果往往相互矛盾,在所研究的生物标志物、时间点、胎龄以及所使用的 FGR 和 SGA 定义方面普遍存在异质性。由于这些差异,很难从结果中得出有力的结论。应继续寻找FGR和SGA新生儿脑损伤的血液生物标志物,因为早期检测和干预对改善这些新生儿的预后至关重要。
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引用次数: 0
Quantification of Diffusion Magnetic Resonance Imaging for Prognostic Prediction of Neonatal Hypoxic-Ischemic Encephalopathy. 弥散核磁共振成像定量预测新生儿缺氧缺血性脑病的预后。
IF 2.3 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2024-01-01 Epub Date: 2023-05-10 DOI: 10.1159/000530938
Kengo Onda, Raul Chavez-Valdez, Ernest M Graham, Allen D Everett, Frances J Northington, Kenichi Oishi

Neonatal hypoxic-ischemic encephalopathy (HIE) is the leading cause of acquired neonatal brain injury with the risk of developing serious neurological sequelae and death. An accurate and robust prediction of short- and long-term outcomes may provide clinicians and families with fundamental evidence for their decision-making, the design of treatment strategies, and the discussion of developmental intervention plans after discharge. Diffusion tensor imaging (DTI) is one of the most powerful neuroimaging tools with which to predict the prognosis of neonatal HIE by providing microscopic features that cannot be assessed by conventional magnetic resonance imaging (MRI). DTI provides various scalar measures that represent the properties of the tissue, such as fractional anisotropy (FA) and mean diffusivity (MD). Since the characteristics of the diffusion of water molecules represented by these measures are affected by the microscopic cellular and extracellular environment, such as the orientation of structural components and cell density, they are often used to study the normal developmental trajectory of the brain and as indicators of various tissue damage, including HIE-related pathologies, such as cytotoxic edema, vascular edema, inflammation, cell death, and Wallerian degeneration. Previous studies have demonstrated widespread alteration in DTI measurements in severe cases of HIE and more localized changes in neonates with mild-to-moderate HIE. In an attempt to establish cutoff values to predict the occurrence of neurological sequelae, MD and FA measurements in the corpus callosum, thalamus, basal ganglia, corticospinal tract, and frontal white matter have proven to have an excellent ability to predict severe neurological outcomes. In addition, a recent study has suggested that a data-driven, unbiased approach using machine learning techniques on features obtained from whole-brain image quantification may accurately predict the prognosis of HIE, including for mild-to-moderate cases. Further efforts are needed to overcome current challenges, such as MRI infrastructure, diffusion modeling methods, and data harmonization for clinical application. In addition, external validation of predictive models is essential for clinical application of DTI to prognostication.

新生儿缺氧缺血性脑病(HIE)是新生儿后天性脑损伤的主要原因,有可能导致严重的神经系统后遗症和死亡。准确、可靠地预测短期和长期预后可为临床医生和家属的决策、治疗策略的设计以及出院后发展干预计划的讨论提供基本证据。弥散张量成像(DTI)提供了传统磁共振成像无法评估的微观特征,是预测新生儿 HIE 预后的最强大的神经成像工具之一。DTI 可提供代表组织特性的各种标量,如分数各向异性(FA)和平均扩散率(MD)。由于这些指标所代表的水分子扩散特性受到微观细胞和细胞外环境的影响,如结构成分的取向和细胞密度,因此它们通常被用来研究大脑的正常发育轨迹,并作为各种组织损伤的指标,包括与 HIE 相关的病理现象,如细胞毒性水肿、血管水肿、炎症、细胞死亡和沃勒变性。以往的研究表明,在重度 HIE 病例中,DTI 测量值发生了广泛的改变,而在轻度至中度 HIE 的新生儿中,DTI 测量值则发生了较为局部的改变。为了确定预测神经系统后遗症发生的临界值,在胼胝体(CC)、丘脑、基底节、皮质脊髓束(CST)和额叶白质中测量的MD和FA被证明具有很好的预测严重神经系统后遗症的能力。此外,最近的一项研究表明,利用机器学习技术对全脑图像量化获得的特征进行数据驱动的无偏见方法可以准确预测 HIE 的预后,包括轻中度病例。还需要进一步努力克服当前面临的挑战,如磁共振成像基础设施、扩散建模方法和临床应用数据的统一。此外,预测模型的外部验证对于 DTI 在预后方面的临床应用至关重要。
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引用次数: 0
Disrupted Small-World Networks in Children with Drug-Naïve Attention-Deficit/Hyperactivity Disorder: A DTI-Based Network Analysis. 药物治疗无效的注意力缺陷/多动障碍儿童的小世界网络紊乱:基于 DTI 的网络分析
IF 2.9 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2024-01-01 Epub Date: 2023-08-02 DOI: 10.1159/000533128
Liuhui Wu, Shu Su, Yan Dai, Huaqiong Qiu, Liping Lin, Mengsha Zou, Long Qian, Meina Liu, Hongyu Zhang, Yingqian Chen, Zhiyun Yang

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders, while the potential neurological mechanisms are poorly understood. To explore the alterations in the white matter (WM) structural connectome in children with drug-naïve ADHD, forty-nine ADHD and 51 age- and gender-matched typically developing (TD) children aged 6-14 years were enrolled. WM structural connectivity based on deterministic diffusion tensor imaging (DTI) was constructed in 90 cortical and subcortical regions, and topological parameters of the resulting graphs were calculated. Network metrics were compared between two groups. The concentration index and the total cancellation test scores of digit cancellation test were used to evaluate clinical symptom severity in ADHD. Then, a partial correlation analysis was performed to explore the relationship between significant topologic metrics and clinical symptom severity. Compared to TD group, ADHD showed an increase in the characteristic path length (Lp), normalized clustering coefficient (γ), small worldness (σ), and a decrease in the global efficiency (Eglob) (all p < 0.05). Furthermore, ADHD showed reduced nodal centralities mainly in the regions of default mode network (DMN), central executive network (CEN), basal ganglia, and bilateral thalamus (all p < 0.05). After performing Benjamini-Hochberg's procedure, only the left orbital part of superior frontal gyrus and the left caudate were statistically significant (p < 0.05, FDR-corrected). In addition, the concentration index of ADHD was negatively correlated with the nodal betweenness of the left orbital part of the middle frontal gyrus (r = -0.302, p = 0.042). Our findings revealed an ADHD-related shift of WM network topology toward "regularization" pattern, characterized by decreased global network integration, which is also reflected by changed nodal centralities involving DMN, CEN, basal ganglia, and bilateral thalamus. ADHD could be understood by examining the dysfunction of large-scale spatially distributed neural networks.

注意力缺陷/多动障碍(ADHD)是最常见的神经发育障碍之一,但人们对其潜在的神经机制却知之甚少。为了探索药物治疗无效的多动症儿童的白质(WM)结构连接组的改变,研究人员招募了49名多动症儿童和51名年龄和性别匹配的发育典型(TD)儿童,年龄在6-14岁之间。根据确定性弥散张量成像(DTI)在90个皮层和皮层下区域构建了WM结构连接,并计算了由此产生的图形的拓扑参数。比较了两组之间的网络指标。浓度指数和数字消除测试总分用于评估多动症的临床症状严重程度。然后,进行偏相关分析,探讨重要拓扑指标与临床症状严重程度之间的关系。与TD组相比,ADHD表现出特征路径长度(Lp)、归一化聚类系数(γ)、小世界性(σ)的增加,以及全局效率(Eglob)的降低(所有P均为0.05)。此外,ADHD主要在默认模式网络(DMN)、中央执行网络(CEN)、基底节和双侧丘脑等区域表现出节点中心性降低(均为p < 0.05)。经过本杰明-霍奇伯格(Benjamini-Hochberg's)检验,只有额上回左眶部和左尾状核具有统计学意义(经FDR校正,p < 0.05)。此外,多动症的集中指数与额叶中回左眶部分的结节间度呈负相关(r = -0.302,p = 0.042)。我们的研究结果表明,与ADHD相关的WM网络拓扑结构向 "规则化 "模式转变,其特点是全局网络整合性降低,这也反映在涉及DMN、CEN、基底节和双侧丘脑的节点中心性改变上。通过研究大规模空间分布神经网络的功能障碍,可以理解多动症。
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引用次数: 0
miR-26a Improves Microglial Activation and Neuronal Apoptosis in a Rat Model of Cerebral Infarction by Regulating the TREM1-TLR4/MyD88/NF-κB Axis. miR-26a 通过调节 TREM1-TLR4/MyD88/NF-κB 轴改善脑梗死大鼠模型中的小胶质细胞活化和神经元凋亡
IF 2.3 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2024-01-01 Epub Date: 2023-09-13 DOI: 10.1159/000533813
Daxiong Xu, Qi'an Guo

Emerging studies have indicated that abnormally expressed microRNAs (miRNAs) are related to the pathogenesis of cerebral ischemia. Nevertheless, the function of miR-26a in neuronal damage and microglial activation during cerebral infarction remains elusive. It was revealed that miR-26a was downregulated in oxygen-glucose deprivation (OGD)-treated microglia and neurons. Overexpressing miR-26a reduced the inflammatory reaction in BV2 cells and decreased neuronal apoptosis following OGD stimulation. miR-26a upregulation inactivated the TLR4/MyD88/NF-κB pathway and inhibited TREM1 expression. Repressing NF-κB phosphorylation inhibited the miR-26a level. As supported by the dual-luciferase reporter assay, TREM1 was directly targeted by miR-26a. Furthermore, a rat model of middle cerebral artery occlusion (MCAO) was built. We discovered that miR-26a improved cognitive, learning, and motor functions and reduced cerebral edema in MCAO rats. Mechanistically, upregulating miR-26a reduced inflammation and neuronal apoptosis by mitigating the TREM1-TLR4/MyD88/NF-κB pathway in the MCAO rat model. Collectively, this study verified that the miR-26a-TREM1-TLR4/MyD88/NF-κB axis contributes to modulating OGD-mediated microglial activation and neuronal injury.

新近的研究表明,表达异常的微RNA(miRNA)与脑缺血的发病机制有关。然而,miR-26a 在脑梗死过程中神经元损伤和小胶质细胞活化中的功能仍不明确。研究发现,在氧-葡萄糖剥夺(OGD)处理的小胶质细胞和神经元中,miR-26a被下调。miR-26a的上调使TLR4/MyD88/NF-κB通路失活,并抑制了TREM1的表达。抑制 NF-κB 磷酸化可抑制 miR-26a 水平。双荧光素酶报告实验证明,miR-26a 可直接靶向 TREM1。此外,我们还建立了大脑中动脉闭塞(MCAO)大鼠模型。我们发现,miR-26a能改善MCAO大鼠的认知、学习和运动功能,减轻脑水肿。从机理上讲,上调 miR-26a 可通过减轻 TREM1-TLR4/MyD88/NF-κB 通路来减少 MCAO 大鼠模型中的炎症和神经细胞凋亡。总之,这项研究验证了miR-26a-TREM1-TLR4/MyD88/NF-κB轴有助于调节OGD介导的小胶质细胞活化和神经元损伤。
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引用次数: 0
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Developmental Neuroscience
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