Antioxidant Therapy in Neonatal Hypoxic Ischemic Encephalopathy: Adjuvant or Future Alternative to Therapeutic Hypothermia?
Background: Oxidative stress-related diseases in newborns arise from pro-oxidant/antioxidant imbalance in both term and preterm neonates. Pro-oxidant/antioxidant imbalance has shown to be present in different pathological conditions such as hypoxic ischemic encephalopathy (HIE), retinopathy of prema...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-11-01
|
| Series: | Metabolites |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2218-1989/14/11/630 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850267014274220032 |
|---|---|
| author | Veronica Notarbartolo Bintu Ayla Badiane Vita Maria Angileri Ettore Piro Mario Giuffrè |
| author_facet | Veronica Notarbartolo Bintu Ayla Badiane Vita Maria Angileri Ettore Piro Mario Giuffrè |
| author_sort | Veronica Notarbartolo |
| collection | DOAJ |
| description | Background: Oxidative stress-related diseases in newborns arise from pro-oxidant/antioxidant imbalance in both term and preterm neonates. Pro-oxidant/antioxidant imbalance has shown to be present in different pathological conditions such as hypoxic ischemic encephalopathy (HIE), retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), and patent ductus arteriosus (PDA). Methods and Results: We performed a narrative review according to the most recent available literature (2012–2024), using Scopus and PubMed as electronic databases. Many observational and experimental studies in vitro and in vivo have evaluated the effectiveness of antioxidant therapies such as melatonin, erythropoietin (EPO), allopurinol, N-acetylcisteine (NAS), and nitric oxide synthase (NOS) inhibitors in these diseases. Perinatal asphyxia is one of the most important causes of mortality and morbidity in term and near-term newborns. Therapeutic hypothermia (TH) is the gold standard treatment for neonates with moderate-severe perinatal asphyxia, resulting in a reduction in the mortality and neurodevelopmental disability rates. Conclusions: According to the most recent literature and clinical trials, melatonin, allopurinol, NAS, NOS inhibitors, magnesium sulfate, and stem cells stand out as promising as both adjuvants and future probable alternatives to TH in the treatment of HIE. |
| format | Article |
| id | doaj-art-d757dc14bc2c482b8b9f08c8338ca61f |
| institution | OA Journals |
| issn | 2218-1989 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Metabolites |
| spelling | doaj-art-d757dc14bc2c482b8b9f08c8338ca61f2025-08-20T01:53:57ZengMDPI AGMetabolites2218-19892024-11-01141163010.3390/metabo14110630Antioxidant Therapy in Neonatal Hypoxic Ischemic Encephalopathy: Adjuvant or Future Alternative to Therapeutic Hypothermia?Veronica Notarbartolo0Bintu Ayla Badiane1Vita Maria Angileri2Ettore Piro3Mario Giuffrè4Neonatology and Neonatal Intensive Care Unit, University Hospital “Paolo Giaccone”, 90127 Palermo, ItalyDepartment of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, ItalyNeonatal Intensive Care Unit with Neonatology, “G.F. Ingrassia” Hospital Unit, 90131 Palermo, ItalyDepartment of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, ItalyDepartment of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, ItalyBackground: Oxidative stress-related diseases in newborns arise from pro-oxidant/antioxidant imbalance in both term and preterm neonates. Pro-oxidant/antioxidant imbalance has shown to be present in different pathological conditions such as hypoxic ischemic encephalopathy (HIE), retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), and patent ductus arteriosus (PDA). Methods and Results: We performed a narrative review according to the most recent available literature (2012–2024), using Scopus and PubMed as electronic databases. Many observational and experimental studies in vitro and in vivo have evaluated the effectiveness of antioxidant therapies such as melatonin, erythropoietin (EPO), allopurinol, N-acetylcisteine (NAS), and nitric oxide synthase (NOS) inhibitors in these diseases. Perinatal asphyxia is one of the most important causes of mortality and morbidity in term and near-term newborns. Therapeutic hypothermia (TH) is the gold standard treatment for neonates with moderate-severe perinatal asphyxia, resulting in a reduction in the mortality and neurodevelopmental disability rates. Conclusions: According to the most recent literature and clinical trials, melatonin, allopurinol, NAS, NOS inhibitors, magnesium sulfate, and stem cells stand out as promising as both adjuvants and future probable alternatives to TH in the treatment of HIE.https://www.mdpi.com/2218-1989/14/11/630therapeutic hypothermiaasphyxiahypoxic ischemic encephalopathyantioxidantsoxygen reactive species (ROS)hypoxia |
| spellingShingle | Veronica Notarbartolo Bintu Ayla Badiane Vita Maria Angileri Ettore Piro Mario Giuffrè Antioxidant Therapy in Neonatal Hypoxic Ischemic Encephalopathy: Adjuvant or Future Alternative to Therapeutic Hypothermia? Metabolites therapeutic hypothermia asphyxia hypoxic ischemic encephalopathy antioxidants oxygen reactive species (ROS) hypoxia |
| title | Antioxidant Therapy in Neonatal Hypoxic Ischemic Encephalopathy: Adjuvant or Future Alternative to Therapeutic Hypothermia? |
| title_full | Antioxidant Therapy in Neonatal Hypoxic Ischemic Encephalopathy: Adjuvant or Future Alternative to Therapeutic Hypothermia? |
| title_fullStr | Antioxidant Therapy in Neonatal Hypoxic Ischemic Encephalopathy: Adjuvant or Future Alternative to Therapeutic Hypothermia? |
| title_full_unstemmed | Antioxidant Therapy in Neonatal Hypoxic Ischemic Encephalopathy: Adjuvant or Future Alternative to Therapeutic Hypothermia? |
| title_short | Antioxidant Therapy in Neonatal Hypoxic Ischemic Encephalopathy: Adjuvant or Future Alternative to Therapeutic Hypothermia? |
| title_sort | antioxidant therapy in neonatal hypoxic ischemic encephalopathy adjuvant or future alternative to therapeutic hypothermia |
| topic | therapeutic hypothermia asphyxia hypoxic ischemic encephalopathy antioxidants oxygen reactive species (ROS) hypoxia |
| url | https://www.mdpi.com/2218-1989/14/11/630 |
| work_keys_str_mv | AT veronicanotarbartolo antioxidanttherapyinneonatalhypoxicischemicencephalopathyadjuvantorfuturealternativetotherapeutichypothermia AT bintuaylabadiane antioxidanttherapyinneonatalhypoxicischemicencephalopathyadjuvantorfuturealternativetotherapeutichypothermia AT vitamariaangileri antioxidanttherapyinneonatalhypoxicischemicencephalopathyadjuvantorfuturealternativetotherapeutichypothermia AT ettorepiro antioxidanttherapyinneonatalhypoxicischemicencephalopathyadjuvantorfuturealternativetotherapeutichypothermia AT mariogiuffre antioxidanttherapyinneonatalhypoxicischemicencephalopathyadjuvantorfuturealternativetotherapeutichypothermia |