CommentaryWhich Neuroprotective Agents are Ready for Bench to Bedside Translation in the Newborn Infant?
Section snippets
Methods
A systematic PubMed search up to June 2011 was undertaken to identify medications with evidence of neuroprotection in pre-clinical studies when given either antenatally or postnatally after perinatal hypoxia-ischemia. For antenatal treatments, each medication was scored to a manual score of 60 by using 6 questions, each ranked 1 to 10: (1) placental transfer; (2) ease of administration; (3) knowledge about starting dose; (4) adverse effects; (5) teratological or toxic effects; and (6) overall
Results
Thirteen neuroprotective medications were identified. The possible mechanisms of action are shown in the Figure. They were classified as US Food and Drug Administration (FDA)-approved (adenosine A2A receptor antagonist, allopurinol, erythropoietin [Epo], melatonin, memantine, N-acetylcysteine [NAC], resveratrol, topiramate, vitamins C & E, tetrahydrobiopterin [BH4]) and non-FDA-approved (Epo-mimetic peptides, neuronal nitric oxide synthase [nNOS] inhibitors, xenon).
Discussion
The opinions expressed in this review are meant to generate further discussion and to promote international co-ordination; they are not meant as firm recommendations. Both the choice of agent and the scores are subjective, but are informed by the authors’ earlier experience and knowledge. We acknowledge that many new promising drugs, some of which target specific pathways,156 have been left out. However, this is an ongoing process, and the study group plans to continuously update the priority
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The authors declare no conflicts of interest.