Effects of Antenatal Glucocorticoid Therapy on Hippocampal Histology of Preterm Infants 英文参考文献.docVIP

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Effects of Antenatal Glucocorticoid Therapy on Hippocampal Histology of Preterm Infants 英文参考文献.doc

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Effects of Antenatal Glucocorticoid Therapy on Hippocampal Histology of Preterm Infants 英文参考文献

EffectsofAntenatalGlucocorticoidTherapyon HippocampalHistologyofPretermInfants DeodataTijsseling1*.,LiaD.E.Wijnberger2.,JanB.Derks1,CindyT.J.vanVelthoven3,WillemB.de Vries1,FrankvanBel1,PeterG.J.Nikkels4,GerardH.A.Visser1 1Perinatal Center, University Medical Center, Utrecht, The Netherlands, 2Department of Obstetrics and Gynaecology, Rijnstate Hospital, Arnhem, The Netherlands, 3LaboratoryforNeuroimmunologyandDevelopmentalOriginsofDisease,UniversityMedicalCenter,Utrecht,TheNetherlands,4DepartmentofPathology,University MedicalCenter,Utrecht,TheNetherlands Abstract Objective: To investigate if antenatal glucocorticoid treatment has an effect on hippocampal histology of the human pretermnewborn. PatientsandMethods:Includedwereconsecutiveneonateswithagestationalagebetween24and32weeks,whowere born between 1991 to 2009, who had died within 4 days after delivery and underwent brain autopsy. Excluded were neonateswithcongenitalmalformationsandneonatestreatedpostnatallywithglucocorticoids. Thebrainswereroutinely fixed,samplesofthehippocampuswerestainedwithhaematoxylinandeosinandsectionswereexaminedforpresenceor absence of large and small neurons in regions of the hippocampus. Additional staining with GFAP, neurofilament and vimentinwasperformedtoevaluategliosisandmyelination.TheproliferationmarkerKi67wasusedtoevaluateneuronal proliferation.Stainingwithacidfuchsin-thioninwasperformedtoevaluateischemicdamage. Results:Thehippocampioftenneonateswhohadbeentreatedwithantenatalglucocorticoidsshowedalowerdensityof large neurons (p=0.01) and neurons irrespective of size (p=0.02) as compared to eleven neonates who had not been treatedwithglucocorticoids.Nodifferencewasfoundindensityofsmallneurons,inmyelination,gliosis,proliferationor ischemicdamage. Conclusion: We found a significantly lower density of neurons in the hippocampus of neonates after antenatal glucocorticoidtreatment.Althoughthepathophysiologicalandclinicalinterpretationsofthesefindingsarenotclear,they areconsisten