Emerging neuroprotective interventions in periventricular leukomalacia - A systematic review of preclinical studies.

Autor:	Abiramalatha T; Consultant Neonatologist, Kovai Medical Center and Hospital (KMCH), Coimbatore, India.; Department of Pediatrics and Neonatology, KMCH Institute of Health Sciences and Research, Coimbatore, India., Ramaswamy VV; Consultant Neonatologist, Ankura Hospital for Women and Children, Hyderabad, India., Ponnala AK; Centre for Toxicology and Developmental Research (CEFTE), Sri Ramachandra Institute of Higher Education and Research, Chennai, India., Kallem VR; Consultant Neonatologist, Paramitha Children's Hospital, Hyderabad, India., Murkunde YV; Centre for Toxicology and Developmental Research (CEFTE), Sri Ramachandra Institute of Higher Education and Research, Chennai, India., Punnoose AM; Department of Stem Cell Research and Regenerative Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, India., Vivekanandhan A; Department of Genetics, University of Madras, Chennai, India., Pullattayil AK; Health Sciences Librarian, Queen's University, Kingston, Canada., Amboiram P; Department of Neonatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.
Jazyk:	angličtina
Zdroj:	Expert opinion on investigational drugs [Expert Opin Investig Drugs] 2022 Mar; Vol. 31 (3), pp. 305-330. Date of Electronic Publication: 2022 Feb 24.
DOI:	10.1080/13543784.2022.2040479
Abstrakt:	Introduction: Periventricular leukomalacia (PVL) is a result of various antenatal, intrapartum, or postnatal insults to the developing brain and is an important harbinger of cerebral palsy in preterm neonates. There is no proven therapy for PVL. This calls for appraisal of targeted therapies that have been investigated in animal models to evaluate their relevance in a clinical research context. Areas Covered: This systematic review identifies interventions that were evaluated in preclinical studies for neuroprotective efficacy against PVL. We identified 142 studies evaluating various interventions in PVL animal models (search method is detailed in section 2). Expert Opinion: Interventions that have yielded significant results in preclinical research, and that have been evaluated in a limited number of clinical trials include stem cells, erythropoietin, and melatonin. Many other therapeutic modalities evaluated in preclinical studies have been identified, but more data on their neuroprotective potential in PVL must be garnered before they can be considered for clinical trials. Because most of the tested interventions had only a partial efficacy, a combination of interventions that could be synergistic should be investigated in future preclinical studies. Furthermore, since the nature and pattern of perinatal insults to preterm brain predisposing it to PVL are substantially variable, individualized approaches for the choice of appropriate neuroprotective interventions tailored to different subgroups of preterm neonates should be explored.
Databáze:	MEDLINE
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