During the interval between the 22nd and 37th week of gestation, several important events for neurogenesis occur, birth at this stage interrupts this process and provides an immaturity in the central nervous system in the newborn (NB), who ends up being exposed to a variety of insults . When compared to full-term babies, we can observe in the short term a greater vulnerability to cerebral palsy, intellectual disability, deafness and blindness; and in the long term to increased risk of psychiatric disorders. As a result, there is a need to implement strategies and seek to expand the arsenal of neuroprotective drugs aimed at preventing these complications. Erythropoietin appears as a promising candidate, since its expression occurs in different tissues, including the central nervous system. Its synthesis in the brain is dependent on the hypoxia-inducible factor, which is released under conditions of oxidative stress, hypoxia and hypoglycemia. Despite having clinical use as a stimulator of erythropoiesis, recent studies have broadened its spectrum of action linked to several important functions, such as: inhibition of apoptosis, neurotrophic action, expanding role in angiogenesis, elimination of antioxidant agents and anti-inflammatory action. The aim of this study was to investigate the possible neuroprotective effect of erythropoietin in preterm newborns, observing the specificities and variations in application protocols, the efficacy and possible adverse effects involved in its use. The study is an integrative descriptive review of clinical trials literature, in which the electronic databases PUBMED, Scielo and LILACS were consulted retrospectively over the last 10 years, using the health sciences descriptors: prematurity, neuroprotection and erythropoietin. The search was limited to articles written in Portuguese, English and Spanish. 74 articles were found in the search, however, after
analysis four articles were selected; one published in 2010, another in 2016 and two in 2020; a total of 1335 patients in different age groups were evaluated, 693 of these underwent treatment with rhEPO. There was no pattern observed in rhEPO administration regimens, with clinical trials varying its dose and posology, but it was seen that there is a tendency to use high initial therapeutic doses and some authors perform maintenance regimens. None of the authors observed adverse effects of the use of rhEPO in their studies, thus allowing to conclude that its administration is safe. Only one of the clinical trials observed efficacy in the use of rhEPO as a neuroprotective drug, precisely this one that evaluated patients in a later age group (10 and 13 years), the other three did not find statistically relevant neuroprotective effects in their studies. Thus, it is observed that the best time to start treatment and its duration, the ideal dose, the population that will benefit most and the duration of follow-up is still being searched for, so that a definitive conclusion on the therapeutic potential of erythropoietin in preterm infants is still being sought. is found. It is necessary to produce more studies so that the questions raised are fully elucidated and the neuroprotective effect of erythropoietin in premature infants is proven or discarded.
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