Inflammatory Injury to the Neonatal Brain – What Can We Do?

Abstract

Perinatal brain damage is one of the leading causes of life long disability. This damage could be hypoxic–ischemic, inflammatory, or both. This mini-review discusses different interventions aiming at minimizing inflammatory processes in the neonatal brain, both before and after insult. Current options of anti-inflammatory measures for neonates remain quite limited. We describe current anti-inflammatory intervention strategies such as avoiding perinatal infection and inflammation, and reducing exposure to inflammatory processes. We describe the known effects of anti-inflammatory drugs such as steroids, antibiotics, and indomethacin, and the possible anti-inflammatory role of other substances such as IL-1 receptor antagonists, erythropoietin, caffeine, estradiol, insulin-like growth factor, and melatonin as well as endogenous protectors, and genetic regulation of inflammation. If successful, these may decrease mortality and long-term morbidity among term and pre-term infants.

Caffeine is a risk factor for osteopenia of prematurity in preterm infants: a cohort study

“…The results of this study revealed a strong correlation between caffeine treatment and the presence of OP. Despite caffeine’s effect on treating apnea of prematurity with favorable long-term outcomes [ 23 ], our study revealed a strong association between cumulative dosage and duration of treatment with caffeine and OP even when controlling for the effect of other risk factors. The results show that the adverse effect of caffeine is more evident in lower gestational age infants, which may be explained by the prolonged half-life of caffeine in their bodies due to diminished kidney abilities to eliminate the caffeine.…”

53: Is Caffeine a Risk Factor for Osteopenia of Prematurity?

“…In spite of the caffeine effect on treating apnea of prematurity with favorable long-term outcomes (Ofek-Shlomai, & Berger, 2014), our study results revealed a strong association between caffeine dose and duration of treatment and OP in longitudinal data analysis even when controlling for the effect of gestational age and weight gain and other medications. It is well studied that caffeine causes calciuria and creates negative calcium balance in preterm infants.…”

Pharmacological approaches to intervention in hypomyelinating and demyelinating white matter pathology

“…Many anti-inflammatory agents have been effective in the perinatal brain (reviewed in Ofek-Shlomai (Ofek-Shlomai and Berger, 2014). These have also been effective against inflammation associated with adult traumatic brain injury (Abdel Baki et al, 2010; Moro and Sutton, 2010) and tissue damage from lipopolysaccharide (Brothers et al, 2010).…”