胎児の早産による網膜症
Ann Hellström1, Lois E H Smith, Olaf Dammann
1Department of Ophthalmology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
Lancet (London, England)
|June 21, 2013
まとめ
早産児における早産性網膜症は,網膜神経血管の成長が妨げられたことから生じる. 酸素,栄養,インスリンのような成長因子1のような重要な要因を最適化することで,重度の視力喪失を防ぐことができます.
科学分野:
- オフタルモロジック (眼科)
- ネオナトロジーの新生児科
- 発達生物学 発達生物学について
背景:
- 時期尚早の新生児の不成熟な網膜は,神経血管の成長を妨げる侮辱に対して脆弱である.
- 早産性網膜症 (ROP) は,停止した血管化 (第1段階) とその後の低酸素駆動性新血管化 (第2段階) を含む.
- 制御された酸素はROPを減少させるが,排除しないため,他の要因を特定する必要がある.
研究 の 目的:
- 早期発達の網膜病に寄与する要因を特定する.
- 重症で視力を脅かすROPとその併発症を予防するための戦略を探求する.
- 胎児の正常な網膜神経血管発達を促進する.
主な方法:
- 早期出産の網膜症に関する既存の文献のレビュー. 早期出産の病原性.
- ハイポキシア,母胎相互作用,低酸素,成長因子の役割の分析.
- 酸素,栄養,特定の要因の正常化を含む予防戦略の議論.
主要な成果:
- ハイパーオキシアと母胎相互作用の障害により,網膜の血管化が停止する.
- 血管化不良の網膜における低酸素は,病理的な血管増殖を刺激する.
- ROPの病原化は,成長因子,酸素,栄養,感染,炎症を含む多因子である.
結論:
- 重度のROPを予防するには,栄養と重要な成長因子を含む酸素以外の要因を制御する必要があります.
- インスリンのような成長因子1と ω-3多不飽和脂肪酸の最適化は極めて重要です.
- 感染症と炎症を抑制することは,正常な神経血管発達をサポートし,ROPの進行を制限します.
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