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Neurological consequences of systemic inflammation in the premature neonate
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Neurological consequences of systemic inflammation in the premature neonate
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Journal Article
Neurological consequences of systemic inflammation in the premature neonate
2017
Overview
Despite substantial progress in neonatal care over the past two decades leading to improved survival of extremely premature infants, extreme prematurity continues to be associated with long term neurodevelopmental impairments. Cerebral white matter injury is the predominant form of insult in preterm brain leading to adverse neurological consequences. Such brain injury pattern and unfavorable neurologic sequelae is commonly encountered in premature infants exposed to systemic inflammatory states such as clinical or culture proven sepsis with or without evidence of meningitis, prolonged mechanical ventilation, bronchopulmonary dysplasia, necrotizing enterocolitis and chorioamnionitis. Underlying mechanisms may include cytokine mediated processes without direct entry of pathogens into the brain, developmental differences in immune response and complex neurovascular barrier system that play a critical role in regulating the cerebral response to various systemic inflammatory insults in premature infants. Understanding of these pathologic mechanisms and clinical correlates of such injury based on serum biomarkers or brain imaging findings on magnetic resonance imaging will pave way for future research and translational therapeutic opportunities for the developing brain.
Publisher
Medknow Publications and Media Pvt. Ltd,Medknow Publications & Media Pvt. Ltd,OMNI Academic Service Line and Division of Neonatology, Department of Pediatrics, Kentucky Children's Hospital, College of Medicine, University of Kentucky, Lexington, KY, USA,Medknow Publications & Media Pvt Ltd,Wolters Kluwer Medknow Publications
