Fetal inflammatory response and brain injury in the preterm newborn.
Preterm birth can be caused by intrauterine infection and maternal/fetal inflammatory responses. Maternal inflammation (chorioamnionitis) is often followed by a systemic fetal inflammatory response characterized by elevated levels of proinflammatory cytokines in the fetal circulation. The inflammation signal is likely transmitted across the blood-brain barrier and initiates a neuroinflammatory response. Microglial activation has a central role in this process and triggers excitotoxic, inflammatory, and oxidative damage in the developing brain. Neuroinflammation can persist over a period of time and sensitize the brain to subinjurious insults in early and chronic phases but may offer relative tolerance in the intermediate period through activation of endogenous anti-inflammatory, protective, and repair mechanisms. Neuroinflammatory injury not only destroys what exists but also changes what develops.
Malaeb
Shadi
S
Division of Newborn Medicine, Floating Hospital for Children, Tufts Medical Center, Boston, Massachusetts 02111, USA. smalaeb1@tuftsmedicalcenter.org
Dammann
Olaf
O
D000818:Animals; D001930:Brain Injuries / Q000209:etiology*; D005333:Fetus; D006801:Humans; D007231:Infant, Newborn; D007249:Inflammation / Q000150:complications*; D047928:Premature Birth / Q000473:pathology / Q000503:physiopathology*