White Matter Injury in Preterm Infants: Pathogenesis and Potential Therapy From the Aspect of the Gut–Brain Axis

Abstract

Very preterm infants who survive are at high risk of white matter injury (WMI). With a greater understanding of the pathogenesis of WMI, the gut microbiota has recently drawn increasing attention in this field. This review tries to clarify the possible mechanisms behind the communication of the gut bacteria and the immature brain via the gut–brain axis. The gut microbiota releases signals, such as microbial metabolites. These metabolites regulate inflammatory and immune responses characterized by microglial activation, which ultimately impact the differentiation of pre-myelinating oligodendrocytes (pre-OLs) and lead to WMI. Moreover, probiotics and prebiotics emerge as a promising therapy to improve the neurodevelopmental outcome. However, future studies are required to clarify the function of these above products and the optimal time for their administration within a larger population. Based on the existing evidence, it is still too early to recommend probiotics and prebiotics as effective treatments for WMI.

Association of Brain Microstructure and Functional Connectivity With Cognitive Outcomes and Postnatal Growth Among Early School–Aged Children Born With Extremely Low Birth Weight

“…The development of thalamic radiation requires a long time from the late embryonic period to the third trimester of gestation . Therefore, the RATR showed a different pattern than the other 4 tracts; for children with PGF, regions of increased FA in the segment of the RATR might be associated with a late compensatory effect to early injury during development . Axonal projections contained within the RATR are known to connect the thalamus, striatum, and frontal lobes and have been implicated in higher-order cognitive functions .…”

“…45 Therefore, the RATR showed a different pattern than the other 4 tracts; for children with PGF, regions of increased FA in the segment of the RATR might be associated with a late compensatory effect to early injury during development. 46,47 Axonal projections contained within the RATR are known to connect the thalamus, striatum, and frontal lobes and have been implicated in higher-order cognitive functions. 48 Injury to or dysmaturity of fiber connections of the thalamic radiations in preterm children may account, in part, for individual variations in behavioral abilities thought to involve functions of the frontal lobes, including attention.…”

A Multiplanar Radiomics Model Based on Cranial Ultrasound to Predict the White Matter Injury in Premature Infants and an Analysis of its Correlation With Neurodevelopment

“…A total of 267 premature infants with high-risk elements for WMI in the neonatal departments of Huazhong University of Science and Technology Union Shenzhen Hospital and Shenzhen Hospital of Southern Medical University between Jan 2019 and Dec 2022 were retrospectively included in the training and verification sets. The inclusion criteria were as follows [21][22][23] : 26 weeks ≤ gestational age < 37 weeks; brain ultrasound examination was completed within 3-7 days after admission, MRI examination completed within 2 weeks after birth; high-risk factors leading to brain oxygen supply, blood supply and metabolic disorders of premature infants: history of asphyxia and hypoxia, perinatal infection, eclampsia, maternal chorioamnionitis, history of mechanical ventilation, intracranial hemorrhage, hypoglycemia, and so on. The exclusion criteria were as follows: craniocerebral structural malformations, severe malformations in other organs, genetic metabolic diseases, and poor-quality two-dimensional ultrasound images (ie, the ultrasound scan of infants with a small fontanel may show a large blind area and unclear image quality).…”

Simulate the Dynamic Interactions Across Nutritional Supplements, the Polybiome, and the Biochemical Approach Dependent on Patient-Derived Gastrointestinal Knowledge

“…To address these issues, several modalities, each with a greater level of complexity than two-dimensional digit types, have already been developed [70][71][72][73][74][75]. Even though these animals and people have comparable metabolic health, their intestinal poly-biomes are not identical, and a human-centered model often misrepresents the genuine relationships occurring in occupants [76][77][78].…”