Show simple item record

dc.contributor.advisorMolloy, Eleanoren
dc.contributor.authorO'DEA, MARY ISABELen
dc.date.accessioned2020-05-25T12:38:19Z
dc.date.available2020-05-25T12:38:19Z
dc.date.issued2020en
dc.date.submitted2020en
dc.identifier.citationO'DEA, MARY ISABEL, UNICORN; Underlying mechanisms in Neonatal Immune Metabolic Dysregulation and Brain Injury, Trinity College Dublin.School of Medicine, 2020en
dc.identifier.otherYen
dc.identifier.urihttp://hdl.handle.net/2262/92670
dc.descriptionAPPROVEDen
dc.description.abstractIntroduction: Neonatal encephalopathy (NE) is a clinically defined syndrome of disturbed neurologic function, in the earliest days of life. NE has a multifactorial aetiology and causes significant mortality and neurological morbidity. Therapeutic hypothermia (TH) is the only available treatment, but morbidity and mortality rates remain high. There is an urgent need for adjunctive therapies to improve neurodevelopmental outcomes. Persistent systemic inflammation has been implicated in the pathogenesis of NE. Identification of novel inflammatory biomarker combinations helped to determine the aetiology of NE and in the development of new adjunctive therapies. Methods: Infants with NE and age matched controls were included to explore their inflammatory phenotype and mitochondrial function to assess immune dysregulation at baseline and following LPS stimulation. This detailed inflammatory phenotype was then correlated with their clinical outcome. Alongside the translational work, a systematic review of biomarkers in NE to predict outcome and a number of clinical management improvement initiatives were prepared. Results: Infants with NE had a dysregulated inflammatory response and their whole blood hypo- responsive to endotoxin stimulation in contrast to the robust innate immune response from term control infants. The inflammatory phenotype correlated with NE clinical outcomes. Management guidelines and two animations on TH were developed in collaboration with parents and best evidenced based review. Conclusion: Systemic inflammation is important in the pathogenesis of NE. Improving the understanding of this inflammatory signature has aided in revealing the pathophysiology, identified relevant biomarkers of severity and shows promise towards new adjunctive therapies.en
dc.publisherTrinity College Dublin. School of Medicine. Discipline of Paediatricsen
dc.rightsYen
dc.subjectNeonatal Encephalopathyen
dc.subjectHypoxia-Ischaemiaen
dc.subjectNewborn Brain Injuryen
dc.subjectTherapeutic Hypothermiaen
dc.subjectNeonatal Inflammatory Phenotypeen
dc.titleUNICORN; Underlying mechanisms in Neonatal Immune Metabolic Dysregulation and Brain Injuryen
dc.typeThesisen
dc.type.supercollectionthesis_dissertationsen
dc.type.supercollectionrefereed_publicationsen
dc.type.qualificationlevelDoctoralen
dc.type.qualificationnameDoctor of Philosophy (Ph.D.)en
dc.identifier.peoplefinderurlhttps://tcdlocalportal.tcd.ie/pls/EnterApex/f?p=800:71:0::::P71_USERNAME:ODEAMIen
dc.identifier.rssinternalid216513en
dc.rights.ecaccessrightsopenAccess
dc.contributor.sponsorNational Children's Research Centreen
dc.contributor.sponsorNational Children's Hospital Foundationen
dc.contributor.sponsorHealth Research Boarden


Files in this item

Thumbnail
Thumbnail

This item appears in the following Collection(s)

Show simple item record