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Antioxidant Strategies and Respiratory Disease of the Preterm Newborn: An Update

机译:早产儿的抗氧化策略和呼吸系统疾病:最新进展

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摘要

Preterm newborns are challenged by an excessive oxidative burden, as a result of several perinatal stimuli, as intrauterine infections, resuscitation, mechanical ventilation, and postnatal complications, in the presence of immature antioxidant capacities. “Oxygen radical disease of neonatology” comprises a wide range of conditions sharing a common pathway of pathogenesis and includes bronchopulmonary dysplasia (BPD) and other main complications of prematurity. Antioxidant strategies may be beneficial in the prevention and treatment of oxidative stress- (OS-) related lung disease of the preterm newborn. Endotracheal supplementation or lung-targeted overexpression of superoxide dismutase was proved to reduce lung damage in several models; however, the supplementation in preterm newborn failed to reduce the risk of BPD, although long-term respiratory outcomes were improved. Also melatonin administration to small cohorts of preterm newborns suggested beneficial effects on lung OS. The possibility to identify single nucleotide polymorphism affecting the risk of BPD may help to identify specific populations with particularly high risk of OS-related diseases and may pose the basis for individually targeted treatments. Finally, surfactant replacement may lead to local anti-inflammatory and antioxidant effects, thanks to specific enzymatic and nonenzymatic antioxidants naturally present in animal surfactants.
机译:在未成熟抗氧化剂的情况下,由于几种围产期刺激,早产儿面临宫内感染,复苏,机械通气和产后并发症等多种围产期刺激,从而受到过度氧化负担的挑战。 “新生儿医学的氧自由基病”包括广泛的病情,共享共同的发病机理,包括支气管肺发育不良(BPD)和其他早产主要并发症。抗氧化剂策略可能有助于预防和治疗早产儿与氧化应激相关的肺部疾病。气管内补充或以肺为目标的超氧化物歧化酶的过度表达在多种模型中均被证明可以减少肺部损伤。然而,尽管改善了长期呼吸结果,但在早产儿中补充营养并不能降低BPD的风险。此外,对少量早产儿队列中的褪黑激素给药也提示了对肺OS的有益作用。鉴定影响BPD风险的单核苷酸多态性的可能性可能有助于鉴定具有OS相关疾病风险特别高的特定人群,并可能为个体靶向治疗奠定基础。最后,由于动物表面活性剂中天然存在的特定酶促和非酶促抗氧化剂,表面活性剂的替代可导致局部抗炎和抗氧化作用。

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