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Challenges for intraventricular hemorrhage research and emerging therapeutic targets

机译:脑室出血研究和新出现治疗目标的挑战

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Introduction: Intraventricular hemorrhage (IVH) affects both premature infants and adults. In both demographics, it has high mortality and morbidity. There is no FDA approved therapy that improves neurological outcome in either population highlighting the need for additional focus on therapeutic targets and treatments emerging from preclinical studies.Areas covered: IVH induces both initial injury linked to the physical effects of the blood (mass effect) and secondary injury linked to the brain response to the hemorrhage. Preclinical studies have identified multiple secondary injury mechanisms following IVH, and particularly the role of blood components (e.g. hemoglobin, iron, thrombin). This review, with an emphasis on pre-clinical IVH research, highlights therapeutic targets and treatments that may be of use in prevention, acute care, or repair of damage.Expert opinion: An IVH is a potentially devastating event. Progress has been made in elucidating injury mechanisms, but this has still to translate to the clinic. Some pathways involved in injury also have beneficial effects (coagulation cascade/inflammation). A greater understanding of the downstream pathways involved in those pathways may allow therapeutic development. Iron chelation (deferoxamine) is in clinical trial for intracerebral hemorrhage and preclinical data suggest it may be a potential treatment for IVH.
机译:简介:脑室内出血(IVH)影响早产儿和成人。在人口统计学中,它具有高死亡率和发病率。没有FDA批准的治疗,可以提高任何人口中的神经结果,突出了从临床前研究中出现的治疗目标和治疗的需求。覆盖:IVH诱导与血液的物理效果相关的初始损伤(质量效应)和二次损伤与脑响应出血的关系。临床前研究已经确定了IVH后的多次次次损伤机制,特别是血液成分的作用(例如血红蛋白,铁,凝血酶)。本综述,重点是临床前IVH研究,突出了可能用于预防,急性护理或修复的治疗目标和治疗.Pert意见:IVH是一个潜在的破坏性事件。在阐明伤害机制方面取得了进展,但这仍然仍然转化为诊所。涉及受伤的一些途径也具有有益的效果(凝血级联/炎症)。对这些途径中涉及的下游途径的更大了解可以允许治疗发育。铁螯合(Deiferoxamine)是脑内出血和临床前数据的临床试验,表明它可能是IVH的潜在处理。

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