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Oxidative Stress in Neonatal Hypoxic-Ischemic Encephalopathy

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Oxidative Stress and Free Radical Damage in Neurology

Abstract

Despite improvements in the care of asphyxiated neonates, neonatal or perinatal hypoxia-ischemia remains a challenge to clinical practitioners. In this multisystem dysfunction, hypoxic-ischemic encephalopathy contributes to short- and long-term morbidity of these critically ill neonates. In the developing brain of premature and term neonates, there are immature responses to hypoxia-ischemia in the context of selective vulnerability of different brain structures and neural cells at different stages of development. This difference explains at least in part the diversity of clinical presentations and sequelae of neonatal hypoxic-ischemic brain injury. In addition to hypoxic-ischemic damage, cerebral reoxygenation or reperfusion injury plays an important role in the pathophysiology of hypoxic-ischemic brain injury. Mechanisms of cell death and apoptosis operate at multiple levels including oxygen-derived free radical damage and excitotoxicity. Cerebral oxidative stress and neurochemical changes are related in hypoxia-ischemia of the neonatal brain. Controlled reoxygenation to avoid hyperoxia and its related cerebral damage, and novel antioxidative agents such as N-acetylcysteine, are potential therapeutic interventions that may show promise in the improvement of clinical outcome of these asphyxiated neonates with cerebral hypoxic-ischemic injury. The effects of controlled reoxygenation and N-acetylcysteine on the neurochemistry of asphyxiated neonatal brain are discussed.

P.-Y. Cheung is a Clinical Investigator of the Canadian Institutes of Health Research and the Alberta Heritage Foundation for Medical Research (AHFMR).

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  1. Department of Pediatrics and Pharmacology, University of Alberta, Edmonton, AB, Canada

    Po-Yin Cheung

Authors
  1. K. G. Todd
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  2. L. L. Jantzie
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  3. Po-Yin Cheung
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Correspondence to Po-Yin Cheung .

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  1. Medical School, Dept. Neurology, Tel Aviv University, Tel Aviv, 69978, Israel

    Natan Gadoth

  2. Neurochirurgische Klinik, Abt. Neuropathologie, Universitätsklinikum Mainz, Langenbeckstr. 1, Mainz, 55131, Germany

    Hans Hilmar Göbel

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© 2011 Springer Science+Business Media, LLC

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Todd, K.G., Jantzie, L.L., Cheung, PY. (2011). Oxidative Stress in Neonatal Hypoxic-Ischemic Encephalopathy. In: Gadoth, N., Göbel, H. (eds) Oxidative Stress and Free Radical Damage in Neurology. Oxidative Stress in Applied Basic Research and Clinical Practice. Humana Press. https://doi.org/10.1007/978-1-60327-514-9_4

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