PGC-1α activity and mitochondrial dysfunction in preterm infants
Atefeh Mohammadi1,2, Randa Higazy1, Estelle B Gauda1,2
1The Hospital for Sick Children, Division of Neonatology, Department of Pediatrics and Translational Medicine Program, Toronto, ON, Canada.
Insights
Extremely low gestational age neonates face mitochondrial dysfunction, risking brain and lung injury. Therapies targeting PGC-1α may improve mitochondrial function and reduce white matter injury and bronchopulmonary dysplasia.
Area of Science:
- Neonatal Medicine
- Mitochondrial Biology
- Developmental Pediatrics
Background:
- Extremely low gestational age neonates (ELGANs) are susceptible to hyperoxia and oxidative stress, leading to mitochondrial dysfunction.
- Mitochondrial dysfunction in neonates significantly impacts the brain and lungs, contributing to white matter injury (WMI) and bronchopulmonary dysplasia (BPD).
- Proper mitochondrial function is crucial for organ development, energy production, and mitigating oxidative stress via reactive oxygen species (ROS) and reactive nitrogen species (RNS).
Purpose of the Study:
- To review therapeutic agents that modulate mitochondrial function by targeting the PGC-1α pathway.
- To explore the potential of PGC-1α activators in mitigating WMI and BPD in ELGANs.
- To identify promising candidates for further pre-clinical and clinical investigation.
Main Methods:
- Literature review of therapeutic agents impacting PGC-1α.
- Analysis of PGC-1α's role in mitochondrial biogenesis and function.
- Identification of agents that activate or upregulate PGC-1α.
Main Results:
- Peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α) is a key regulator of mitochondrial health.
- Several agents, including metformin, resveratrol, omega-3 fatty acids, montelukast, L-citrulline, and adiponectin, show potential for PGC-1α pathway modulation.
- These agents may mitigate mitochondrial dysfunction underlying WMI and BPD.
Conclusions:
- Targeting the PGC-1α pathway represents a promising therapeutic strategy for neonatal mitochondrial dysfunction.
- Metformin, resveratrol, and other agents warrant further investigation for their efficacy in preventing WMI and BPD in preterm infants.
- Understanding PGC-1α's role is critical for developing novel treatments to improve outcomes for ELGANs.
Abstract:
Extremely low gestational age neonates (ELGANs) are born in a relatively hyperoxic environment with weak antioxidant defenses, placing them at high risk for mitochondrial dysfunction affecting multiple organ systems including the nervous, respiratory, ocular, and gastrointestinal systems. The brain and lungs are highly affected by mitochondrial dysfunction and dysregulation in the neonate, causing white matter injury (WMI) and bronchopulmonary dysplasia (BPD), respectively. Adequate mitochondrial function is important in providing sufficient energy for organ development as it relates to alveolarization and axonal myelination and decreasing oxidative stress via reactive oxygen species (ROS) and reactive nitrogen species (RNS) detoxification. Peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α) is a master regulator of mitochondrial biogenesis and function. Since mitochondrial dysfunction is at the root of WMI and BPD pathobiology, exploring therapies that can regulate PGC-1α activity may be beneficial. This review article describes several promising therapeutic agents that can mitigate mitochondrial dysfunction through direct and indirect activation and upregulation of the PGC-1α pathway. Metformin, resveratrol, omega 3 fatty acids, montelukast, L-citrulline, and adiponectin are promising candidates that require further pre-clinical and clinical studies to understand their efficacy in decreasing the burden of disease from WMI and BPD in preterm infants.
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