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Monocytes in neonatal stroke and hypoxic-ischemic encephalopathy: Pathophysiological mechanisms and therapeutic

Pedro M Pimentel-Coelho1

  • 1Carlos Chagas Filho Biophysics Institute Federal University of Rio de Janeiro Rio de Janeiro Brazil.

Neuroprotection (Chichester, England)
|December 12, 2025
PubMed

Insights

Neonatal stroke and hypoxic-ischemic encephalopathy involve immune cell infiltration into the brain. Understanding monocyte roles in these conditions is crucial for developing new infant neurological treatments.

Area of Science:

  • Neuroscience
  • Immunology
  • Neonatal Medicine

Background:

  • Neonatal arterial ischemic stroke (NAIS) and neonatal hypoxic-ischemic encephalopathy (HIE) are significant causes of infant neurological deficits with limited treatments.
  • These conditions trigger innate immune responses, recruiting peripheral immune cells like monocytes to the brain.
  • The dual role of monocytes/monocyte-derived cells in neuroinflammation and brain repair in NAIS and HIE is not fully understood.

Purpose of the Study:

  • To comprehensively review monocyte infiltration mechanisms and functions in the ischemic brain, specifically in NAIS and HIE.
  • To explore the potential long-term consequences of persistent monocyte-derived macrophages in the neonatal brain.
  • To discuss therapeutic strategies targeting monocytes and their potential for cell-based therapies.

Main Methods:

  • Literature review focusing on monocyte infiltration and function in neonatal stroke and HIE.
  • Analysis of current evidence regarding immune cell recruitment and persistence in the neonatal brain.
  • Synthesis of information on therapeutic approaches and cell-based therapy potential.

Main Results:

  • Monocyte infiltration is a key feature of the innate immune response in NAIS and HIE.
  • Monocytes and derived macrophages may play complex roles in both damaging neuroinflammation and beneficial brain repair.
  • Evidence suggests monocyte-derived macrophages can persist long-term in the brain post-insult, with unknown consequences.

Conclusions:

  • Further research is needed to elucidate the precise roles of monocytes in neonatal ischemic brain injury.
  • Targeting monocyte pathways presents a potential therapeutic avenue for NAIS and HIE.
  • Monocyte-based cell therapies warrant investigation for treating neonatal neurological impairments.

Keywords:
bone marrowcerebral ischemiamicrogliamonocytesmonocyte‐derived macrophagesneonatal brain injuryneonatal hypoxia‐ischemiaperinatal stroke

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