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Published on: November 20, 2015
The role of inflammation in perinatal brain injury
Henrik Hagberg1, Carina Mallard2, Donna M Ferriero3
11] Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St Thomas' Hospital, London SE1 7EH, UK. [2] Perinatal Center, Institute of Physiology and Neurosciences and Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 435 43 Gothenburg, Sweden.
Insights
Immune responses in the developing brain differ significantly from adults. Understanding these differences in neuroinflammation is crucial for predicting and managing perinatal brain injury outcomes.
Area of Science:
- Neuroscience
- Immunology
- Developmental Biology
Background:
- Inflammation critically impacts immature brain development and injury outcomes.
- Immune responses in the immature brain exhibit key differences compared to adult brains.
- Perinatal brain injuries, including neonatal encephalopathy and stroke, are influenced by inflammation.
Purpose of the Study:
- To review critical differences in innate and adaptive immunity between immature and adult brains.
- To elucidate how inflammation modulates vulnerability and development of perinatal brain injury.
- To highlight the long-term consequences of perinatal neuroinflammation on neurological and neuropsychiatric health.
Main Methods:
- Review of existing literature on neuroinflammation in perinatal brain development and injury.
- Comparative analysis of immune system maturation in immature versus adult central nervous system (CNS).
- Examination of the temporal relationship between inflammation and brain injury in term and preterm infants.
Main Results:
- Immune responses in the immature brain are distinct, leading to different consequences of inflammation compared to adults.
- Inflammation precedes, accompanies, and follows perinatal brain injury, affecting its severity.
- Preterm birth is often linked to early-life inflammation, impacting postnatal brain development, myelination, and plasticity.
Conclusions:
- The stage of central nervous system (CNS) development dictates the impact of inflammation on brain injury.
- Perinatal neuroinflammation elevates the risk for lifelong neurological and neuropsychiatric disorders.
- Recognizing developmental differences in neuroimmunity is vital for pediatric and adult care providers.
Abstract:
Inflammation is increasingly recognized as being a critical contributor to both normal development and injury outcome in the immature brain. The focus of this Review is to highlight important differences in innate and adaptive immunity in immature versus adult brain, which support the notion that the consequences of inflammation will be entirely different depending on context and stage of CNS development. Perinatal brain injury can result from neonatal encephalopathy and perinatal arterial ischaemic stroke, usually at term, but also in preterm infants. Inflammation occurs before, during and after brain injury at term, and modulates vulnerability to and development of brain injury. Preterm birth, on the other hand, is often a result of exposure to inflammation at a very early developmental phase, which affects the brain not only during fetal life, but also over a protracted period of postnatal life in a neonatal intensive care setting, influencing critical phases of myelination and cortical plasticity. Neuroinflammation during the perinatal period can increase the risk of neurological and neuropsychiatric disease throughout childhood and adulthood, and is, therefore, of concern to the broader group of physicians who care for these individuals.
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