Neonatal hypoxic-ischemic encephalopathy is a disorder with heterogeneous manifestation due to asphyxia during perinatal period. It affects approximately 3-12 children per 1000 live births and cause death of 1 million neonates worldwide per year. Besides, motor disabilities, seizures, impaired muscle tone and epilepsy are few of the consequences of hypoxic-ischemic encephalopathy. Despite an extensive research effort regarding various treatment strategies, therapeutic hypothermia with intensive care unit supportive treatment remains the only approved method for neonates who have suffered from moderate to severe hypoxicischemic encephalopathy. However, these protocols are only partially effective given that many infants still suffer from severe brain damage. Thus, further research to systematically test promising neuroprotective treatments in combination with hypothermia is essential. In this review, we discussed the pathophysiology of hypoxic-ischemic encephalopathy and delved into different promising treatment modalities, such as melatonin and erythropoietin. However, preclinical studies and clinical trials are still needed to further elucidate the mechanisms of action of these modalities.
This study aimed to evaluate the changes in the erythropoietin
level and hematological variables in wrestlers after intermittent
hypoxic exposure (IHE). Twelve wrestlers were assigned into two
groups: hypoxia (sports training combined with IHE, n=6) and
control (sports training, n=6). An IHE was performed for
10 days, with one day off after 6 days, once a day for about
an hour. The concentrations of hydrogen peroxide (H2O2),
nitric oxide (NO), vascular endothelial growth factor (VEGF)
and erythropoietin (EPO), as well as total creatine kinase
activity (CK) were measured. Also, the hematological markers
(Hb -hemoglobin, Ht - hematocrit, RBC - red blood cell, WBC -
white blood cell, Ret - reticulocytes) were analyzed. The 6-day
IHE caused an increase in the levels of H2O2, NO and VEGF.
Similarly, the EPO level and WBC count reached the highest value
after 6 days of IHE. The total Ret number increase constantly
during 10 days of IHE. The hypoxia group showed a higher CK
activity compared to the control. In conclusion, 10-day IHE in
combination with wrestling training elevates levels of H2O2, NO
and VEGF, and improves the oxygen transport capacity by the
release of EPO and Ret in circulation.