Working in the field of Pediatrics experts say that the new standard of treatment, including hypothermia (hypothermia) can help approximately 50% of newborns with moderate and severe hypoxic ischemia.

It is known that approximately half of all affected by hypoxic ischemia in the newborn behind their peers in development, they have a delay in cognitive and motor skills, including cerebral palsy. According to experts, it is clear that to improve outcomes we need to develop new therapeutic methods that include hypothermia.

Многокомпонентный подход к лечению неонатальной гипоксической ишемии

Hypothermia and antioxidant therapy reduces brain damage in mice

In preclinical studies, during which scientists studied the effect of hypothermia and antioxidant therapy N-acetylcysteine (NAC) on newborn mice with neonatal hypoxic ischemia, it was found that this treatment acts as a neuroprotectant. But in females the effect was more pronounced than in mice of the male sex.

In neonatal hypoxic ischemia, the addition of vitamin D to the therapy with NAC and hypothermia improves functional results and preserves brain volume in male mice. This is the conclusion reached by researchers from the Medical University of South Carolina (Medical University of South Carolina). A report on the results of their work, scientists published in the September issue of the journal “Neuropharmacology” (Neuropharmacology).

Dorothea Jenkins (Dorothea Jenkins), doctor of medicine, Professor and physician in the Department of Pediatrics Medical University of South Carolina and senior author, says these therapies can attack the damage with different perspectives, helping different cells at different stages of recovery.

In several trials, it was shown that hypothermia affects a number of different mechanisms of damage, and in newborns, it acts as a neuroprotectant. However, this method may not help children with the most serious violations. Newborns are left with motor and cognitive deficits that at the beginning of the study will lead to problems with learning and remembering.

Vitamin D may improve the treatment of damage caused by hypoxic ischemia

Dr. Jenkins in his earlier article told me that newborn females with severe injuries caused by hypoxic ischemia benefit from combination therapy involving hypothermia and NAC, as it provides the rate limiting amino acid for the formation of the primary antioxidant in all cells. However, newborn males in this treatment the same as females, neuroprotective or functional improvement was observed.

Витамин D может улучшить терапию повреждений, причиненных гипоксической ишемией

Knowing that when neuroinflammation and injuries vitamin D deteriorating, Dr. Jenkins and her team decided to deal with the question whether the addition of vitamin D to hypothermia and NAC to improve the treatment results, especially in male animals.

After a two-week course of this multimodal regime males have a dramatic increase in sensorimotor function (50 to 75 %) and improved working memory and decreased the number of animals with severe brain damage.

However, further analysis showed that proper regulation of vitamin D, the males were still observed.

Despite the dramatic improvements that have taken place under the influence of treatment, young males still showed signs of neuroinflammation and degradation of vitamin D in the body, whereas in females the proper regulation of vitamin D has been restored.

Such sex differences are still under study, and future studies that are planned to conduct this group of scientists, they will be the center of attention.

New treatment methods should take into account gender differences in newborns

A new study found that newborn males and females are especially important in critical periods of development and after traumatic brain injury can be vitamin d deficiency.

Says Dr. Jenkins, until now, scientists have not studied the relationship between damage associated with hypoxic ischemia in neonates and deficient in vitamin D. According to the researcher, it is likely that the time has come to change that.

Tests to measure levels of vitamin D are now being made very quickly, so such testing will be simple and easy change you can make to standard treatment protocols to determine whether sufficient level of this vitamin in the newborn.

Dr. Jenkins and her team plan to use the results of their study in new preclinical and clinical research aimed at improving understanding of the mechanisms of damage, which are based on hypoxic ischemia, and to improve understanding of how these injuries depend on the sex of the newborn. The ultimate goal of the research is to develop accurate methods of treatment based on the sex of the baby.

As noted by Dr. Jenkins, it is an interesting possibility: perhaps for newborn boys and girls require different combinations of drugs.

On materials Medical Xpress

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