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Neuroprotective role of hypothermia in hypoxic-ischemic brain injury: combined therapies using estrogen
Abstract
Hypoxic-ischemic brain injury is a complex network of factors, which is
mainly characterized by a decrease in levels of oxygen concentration and
blood flow, which lead to an inefficient supply of nutrients to the
brain. Hypoxic-ischemic brain injury can be found in perinatal asphyxia
and ischemic-stroke, which represent one of the main causes of mortality
and morbidity in children and adults worldwide. Therefore, knowledge on
underlying mechanisms triggering these insults may help establish
neuroprotective treatments. Selective Estrogen Receptor Modulators and
Selective Tissue Estrogenic Activity Regulators exert several
neuroprotective effects, including decrease of reactive oxygen species,
maintenance of cell viability, mitochondrial survival, among others.
However, these strategies represent a traditional approach of targeting a
single factor of pathology without satisfactory results. Hence,
combined therapies, such as the administration of therapeutic
hypothermia with a complementary neuroprotective agent, constitute a
promising alternative. In this sense, the present review summarizes the
underlying mechanisms of hypoxic-ischemic brain injury and compiles
several neuroprotective strategies, including Selective Estrogen
Receptor Modulators and Selective Tissue Estrogenic Activity Regulators,
which represent putative agents for combined therapies with therapeutic
hypothermia.
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