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Van Steenwinckel J, Bokobza C, Laforge M, Shearer IK, Miron VE, Rua R, Matta SM, Hill‐Yardin EL, Fleiss B, Gressens P. Key roles of glial cells in the encephalopathy of prematurity. Glia 2024; 72:475-503. [PMID: 37909340 PMCID: PMC10952406 DOI: 10.1002/glia.24474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/17/2023] [Accepted: 09/19/2023] [Indexed: 11/03/2023]
Abstract
Across the globe, approximately one in 10 babies are born preterm, that is, before 37 weeks of a typical 40 weeks of gestation. Up to 50% of preterm born infants develop brain injury, encephalopathy of prematurity (EoP), that substantially increases their risk for developing lifelong defects in motor skills and domains of learning, memory, emotional regulation, and cognition. We are still severely limited in our abilities to prevent or predict preterm birth. No longer just the "support cells," we now clearly understand that during development glia are key for building a healthy brain. Glial dysfunction is a hallmark of EoP, notably, microgliosis, astrogliosis, and oligodendrocyte injury. Our knowledge of glial biology during development is exponentially expanding but hasn't developed sufficiently for development of effective neuroregenerative therapies. This review summarizes the current state of knowledge for the roles of glia in infants with EoP and its animal models, and a description of known glial-cell interactions in the context of EoP, such as the roles for border-associated macrophages. The field of perinatal medicine is relatively small but has worked passionately to improve our understanding of the etiology of EoP coupled with detailed mechanistic studies of pre-clinical and human cohorts. A primary finding from this review is that expanding our collaborations with computational biologists, working together to understand the complexity of glial subtypes, glial maturation, and the impacts of EoP in the short and long term will be key to the design of therapies that improve outcomes.
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Affiliation(s)
| | - Cindy Bokobza
- NeuroDiderot, INSERMUniversité Paris CitéParisFrance
| | | | - Isabelle K. Shearer
- School of Health and Biomedical SciencesSTEM College, RMIT UniversityBundooraVictoriaAustralia
| | - Veronique E. Miron
- Barlo Multiple Sclerosis CentreSt. Michael's HospitalTorontoOntarioCanada
- Department of ImmunologyUniversity of TorontoTorontoOntarioCanada
- College of Medicine and Veterinary MedicineThe Dementia Research Institute at The University of EdinburghEdinburghUK
| | - Rejane Rua
- CNRS, INSERM, Centre d'Immunologie de Marseille‐Luminy (CIML), Turing Centre for Living SystemsAix‐Marseille UniversityMarseilleFrance
| | - Samantha M. Matta
- School of Health and Biomedical SciencesSTEM College, RMIT UniversityBundooraVictoriaAustralia
| | - Elisa L. Hill‐Yardin
- School of Health and Biomedical SciencesSTEM College, RMIT UniversityBundooraVictoriaAustralia
| | - Bobbi Fleiss
- NeuroDiderot, INSERMUniversité Paris CitéParisFrance
- School of Health and Biomedical SciencesSTEM College, RMIT UniversityBundooraVictoriaAustralia
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Bhattacharya S, Bennet L, Davidson JO, Unsworth CP. Multi-layer perceptron classification & quantification of neuronal survival in hypoxic-ischemic brain image slices using a novel gradient direction, grey level co-occurrence matrix image training. PLoS One 2022; 17:e0278874. [PMID: 36512546 PMCID: PMC9746996 DOI: 10.1371/journal.pone.0278874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 11/24/2022] [Indexed: 12/15/2022] Open
Abstract
Hypoxic ischemic encephalopathy (HIE) is a major global cause of neonatal death and lifelong disability. Large animal translational studies of hypoxic ischemic brain injury, such as those conducted in fetal sheep, have and continue to play a key role in furthering our understanding of the cellular and molecular mechanisms of injury and developing new treatment strategies for clinical translation. At present, the quantification of neurons in histological images consists of slow, manually intensive morphological assessment, requiring many repeats by an expert, which can prove to be time-consuming and prone to human error. Hence, there is an urgent need to automate the neuron classification and quantification process. In this article, we present a 'Gradient Direction, Grey level Co-occurrence Matrix' (GD-GLCM) image training method which outperforms and simplifies the standard training methodology using texture analysis to cell-classification. This is achieved by determining the Grey level Co-occurrence Matrix of the gradient direction of a cell image followed by direct passing to a classifier in the form of a Multilayer Perceptron (MLP). Hence, avoiding all texture feature computation steps. The proposed MLP is trained on both healthy and dying neurons that are manually identified by an expert and validated on unseen hypoxic-ischemic brain slice images from the fetal sheep in utero model. We compared the performance of our classifier using the gradient magnitude dataset as well as the gradient direction dataset. We also compare the performance of a perceptron, a 1-layer MLP, and a 2-layer MLP to each other. We demonstrate here a way of accurately identifying both healthy and dying cortical neurons obtained from brain slice images of the fetal sheep model under global hypoxia to high precision by identifying the most minimised MLP architecture, minimised input space (GLCM size) and minimised training data (GLCM representations) to achieve the highest performance over the standard methodology.
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Affiliation(s)
- Saheli Bhattacharya
- Department of Engineering Science, The University of Auckland, Auckland, New Zealand
- * E-mail:
| | - Laura Bennet
- Department of Physiology, The University of Auckland, Auckland, New Zealand
| | - Joanne O. Davidson
- Department of Physiology, The University of Auckland, Auckland, New Zealand
| | - Charles P. Unsworth
- Department of Engineering Science, The University of Auckland, Auckland, New Zealand
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Therapeutic potential of stem cells for preterm infant brain damage: Can we move from the heterogeneity of preclinical and clinical studies to established therapeutics? Biochem Pharmacol 2021; 186:114461. [PMID: 33571501 DOI: 10.1016/j.bcp.2021.114461] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/27/2021] [Accepted: 02/02/2021] [Indexed: 12/17/2022]
Abstract
Acquired perinatal brain injuries are a set of conditions that remains a key challenge for neonatologists and that have significant social, emotional and financial implications for our communities. In our perspective article, we will introduce perinatal brain injury focusing specifically on the events leading to brain damage in preterm born infants and outcomes for these infants. Then we will summarize and discuss the preclinical and clinical studies testing the efficacy of stem cells as neuroprotectants in the last ten years in perinatal brain injury. There are no therapies to treat brain damage in preterm born infants and a primary finding from this review is that there is a scarcity of stem cell trials focused on overcoming brain injuries in these infants. Overall, across all forms of perinatal brain injury there is a remarkable heterogeneity in previous and on-going preclinical and clinical studies in terms of the stem cell type, animal models/patient selection, route and time of administration. Despite the quality of many of the studies this variation makes it difficult to reach a valid consensus for future developments. However, it is clear that stem cells (and stem cell derived exosomes) can reduce perinatal brain injury and our field needs to work collectively to refine an effective protocol for each type of injury. The use of standardized stem cell products and testing these products across multiple models of injury will provide a stronger framework for clinical trials development.
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Gussenhoven R, Ophelders DRMG, Dudink J, Pieterman K, Lammens M, Mays RW, Zimmermann LJ, Kramer BW, Wolfs TGAM, Jellema RK. Systemic multipotent adult progenitor cells protect the cerebellum after asphyxia in fetal sheep. Stem Cells Transl Med 2020; 10:57-67. [PMID: 32985793 PMCID: PMC7780812 DOI: 10.1002/sctm.19-0157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 06/29/2020] [Accepted: 08/09/2020] [Indexed: 12/30/2022] Open
Abstract
Involvement of the cerebellum in the pathophysiology of hypoxic‐ischemic encephalopathy (HIE) in preterm infants is increasingly recognized. We aimed to assess the neuroprotective potential of intravenously administered multipotent adult progenitor cells (MAPCs) in the preterm cerebellum. Instrumented preterm ovine fetuses were subjected to transient global hypoxia‐ischemia (HI) by 25 minutes of umbilical cord occlusion at 0.7 of gestation. After reperfusion, two doses of MAPCs were administered intravenously. MAPCs are a plastic adherent bone‐marrow‐derived population of adult progenitor cells with neuroprotective potency in experimental and clinical studies. Global HI caused marked cortical injury in the cerebellum, histologically indicated by disruption of cortical strata, impeded Purkinje cell development, and decreased dendritic arborization. Furthermore, global HI induced histopathological microgliosis, hypomyelination, and disruption of white matter organization. MAPC treatment significantly prevented cortical injury and region‐specifically attenuated white matter injury in the cerebellum following global HI. Diffusion tensor imaging (DTI) detected HI‐induced injury and MAPC neuroprotection in the preterm cerebellum. This study has demonstrated in a preclinical large animal model that early systemic MAPC therapy improved structural injury of the preterm cerebellum following global HI. Microstructural improvement was detectable with DTI. These findings support the potential of MAPC therapy for the treatment of HIE and the added clinical value of DTI for the detection of cerebellar injury and the evaluation of cell‐based therapy.
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Affiliation(s)
- Ruth Gussenhoven
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands.,School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Daan R M G Ophelders
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands.,School of Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Jeroen Dudink
- Department of Neonatology, Wilhelmina Children's Hospital and Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Kay Pieterman
- Biomedical Imaging Group Rotterdam, Department of Radiology and Medical Informatics, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Martin Lammens
- Department of Pathology, Antwerp University Hospital and University of Antwerp, Edegem, Belgium
| | - Robert W Mays
- Regenerative Medicine, Athersys, Inc., Cleveland, Ohio, USA
| | - Luc J Zimmermann
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands.,School of Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Boris W Kramer
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands.,School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,School of Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Tim G A M Wolfs
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands.,School of Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Reint K Jellema
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands
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