Mechanisms of ischemic cell death in the developing brain

Abstract

Understanding the molecular mechanisms underlying the injury response after ischemia in the developing nervous system will allow the rational development of effective therapies. It is unclear whether to target protective mechanisms (via preconditioning), salvaging mechanisms (via "neuroprotective pharmacological therapies), or repair mechanisms (via neurogenesis). Clearly, combination therapies will be required and possibly therapies given at different times (perhaps late) during injury evolution are needed. Recent data on the combined use of hypothermia and topiramate (a drug that decreases AMPA-regulated excitotoxicity) reveal exciting enhanced protection over a single modality (Liu et al., 2004). Encouraging results froma trial of hypothermia for H-I in the term newborn will pave the way for future trials for stroke and H-I in the young brain in the twenty-first century (Gluckman et al., 2004). © 2007 Springer-Verlag US.