Synergistic neuroprotective therapies with hypothermia.
Neuroprotection is a major health care priority, given the enormous burden of human suffering and financial cost caused by perinatal brain damage. With the advent of hypothermia as therapy for term hypoxic-ischemic encephalopathy, there is hope for repair and protection of the brain after a profound neonatal insult. However, it is clear from the published clinical trials and animal studies that hypothermia alone will not provide complete protection or stimulate the repair that is necessary for normal neurodevelopmental outcome. This review critically discusses drugs used to treat seizures after hypoxia-ischemia in the neonate with attention to evidence of possible synergies for therapy. In addition, other agents such as xenon, N-acetylcysteine, erythropoietin, melatonin and cannabinoids are discussed as future potential therapeutic agents that might augment protection from hypothermia. Finally, compounds that might damage the developing brain or counteract the neuroprotective effects of hypothermia are discussed.
Cilio
Maria Roberta
MR
Newborn Brain Research Institute, University of California, San Francisco, California, USA.
Ferriero
Donna M
DM
D000111:Acetylcysteine / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use*; D001831:Body Temperature; D002186:Cannabinoids / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004921:Erythropoietin / Q000627:therapeutic use; D005632:Fructose / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D020925:Hypoxia-Ischemia, Brain / Q000188:drug therapy / Q000628:therapy*; D007231:Infant, Newborn; D000077287:Levetiracetam; D008550:Melatonin / Q000627:therapeutic use; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D010889:Piracetam / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077236:Topiramate; D014978:Xenon / Q000627:therapeutic use
D000927:Anticonvulsants; D002186:Cannabinoids; D018696:Neuroprotective Agents; D000077236:Topiramate; D004921:Erythropoietin; D005632:Fructose; D014978:Xenon; D000077287:Levetiracetam; D008550:Melatonin; D000111:Acetylcysteine; D010889:Piracetam