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Biomedical subjects

Hugo Lagercrantz

Publications and source records attributed to Hugo Lagercrantz.

At least 19 recordsLinked to original sources
PubMed2006

Pain activates cortical areas in the preterm newborn brain.

To study the patterns of supraspinal pain processing in neonates, we hypothesized that acute pain causes haemodynamic changes associated with activation of the primary somatosensory cortex. Forty preterm neonates at 28-36 weeks of gestation (mean=32.0) and at 25-42 h (mean=30.7) of age were studied following standardized tactile (skin disinfection) and painful (venipuncture) stimuli. Changes in regional cerebral haemodynamics were monitored by near infrared spectroscopy (NIRS) over both somatosensory cortices in 29 newborns, and over the contralateral somatosensory and occipital areas in 11 newborns. Heart rate (HR) and peripheral oxygen saturation (SaO2) were recorded simultaneously with NIRS parameters: oxygenated [HbO2], deoxygenated, and total hemoglobin. Tactile stimulation produced no changes in HR or SaO2. HR increased in the first 20s (p<0.001), while SaO2 decreased during the 40s after venipuncture (p<0.0001). Following tactile or painful stimulation, [HbO2] increased bilaterally regardless of which hand was stimulated (p<0.0001). Pain-induced [HbO2] increases in the contralateral somatosensory cortex (p<0.05) were not mirrored in the occipital cortex (p>0.1). Pain-related [HbO2] increases were more pronounced in male neonates (p<0.05 on left, p<0.001 on right), inversely correlated with gestational age (r=-0.53 on left, p<0.01; r=-0.42 on right, p<0.05) and directly correlated with postnatal age (r=0.75 on left, p<0.0001; r=0.67 on right, p<0.0001). Painful and tactile stimuli elicit specific haemodynamic responses in the somatosensory cortex, implying conscious sensory perception in preterm neonates. Somatosensory cortical activation occurs bilaterally following unilateral stimulation and these changes are more pronounced in male neonates or preterm neonates at lower gestational ages.

Brain Mapping↗
PubMed2006

Stop SIDS--sleeping solitary supine, sucking soother, stopping smoking substitutes.

UNLABELLED: The recognition of prone sleeping and maternal smoking as modifiable risk factors for sudden infant death syndrome (SIDS), has drastically decreased SIDS incidence. However, during the last years other factors have become necessary to consider to further reduce the risk of SIDS. Side sleeping implies a greater risk than supine sleeping but is still common. Bed sharing may increase the risk of SIDS, while use of a pacifier seems to be protective. Replacement of maternal smoking with nicotine substitutes is not harmless. CONCLUSION: To further reduce the risk of SIDS, exclusive supine sleeping should be encouraged and side sleeping discouraged. When the breast-feeding is established, a pacifier can very well be used at bedtime. Bed sharing can increase the risk of SIDS if the infant is below 2-3 months of age, especially if the mother is a smoker. Any nicotine use should be avoided during pregnancy and breast-feeding.

Humans↗
PubMed2005

Developmental changes in HIF transcription factor in carotid body: relevance for O2 sensing by chemoreceptors.

Before birth, the peripheral chemoreceptors located in the carotid bodies (CB) are adapted to the low fetal Po(2) and are relatively insensitive to hypoxia. After birth, the sensitivity of the CB to hypoxia is reset in response to the rise in Po(2). The mechanism underlying this resetting, which requires several days to complete, remains unknown. We have investigated the possibility that the hypoxia-inducible factors HIF-1alpha and HIF-2alpha, which are activated by oxygen deprivation, are involved in this resetting process. Accordingly, we used immunostaining and densitometry to quantitate the levels of the HIF-1alpha and HIF-2alpha proteins in the rat CB during early perinatal life and after exposure to in vivo hypoxia during adolescence. Tyrosine hydroxylase (TH) was used as a marker for catecholaminergic neurons and oxygen-sensitive cells in the CB. Double-immunostaining revealed constitutive expression of HIF-1alpha in both glomus cells (TH+) and sustentacular cells (TH-) of the CB of adolescent rats. However, immunoreactivity toward HIF-2alpha was restricted to glomus cells. After exposure to hypoxia (8% O(2), 6 h), the expression of HIF-1alpha was selectively up-regulated in glomus cells and apparent translocation of both HIF-1alpha and HIF-2alpha to the nucleus was observed. Both of these proteins were expressed constitutively in the CB during the perinatal transition period. During the first postnatal week, the intensity of immunostaining for HIF-1alpha in glomus cells decreased markedly, whereas the level of HIF-2alpha remained constant. We suggest that this selective down-regulation of HIF-1alpha may be involved in the postnatal maturation of CB responsiveness to hypoxia.

Active Transport, Cell Nucleus↗
PubMed2005

Neonatal eosinophils possess efficient Eotaxin/IL-5- and N-formyl-methionyl-leucyl-phenylalanine-induced transmigration in vitro.

The majority of premature infants develop eosinophilia and abnormalities in eosinophil trafficking during the first period of postnatal life. We therefore thought to assess the ability of neonatal eosinophils to transmigrate in vitro toward chemotactic stimuli mimic either bacterial infections, or to allergic inflammation in vivo, and to compare the results with eosinophils in adults. We used an in vitro transmigration method and the chemotactic stimuli N-formyl-methionyl-leucyl-phenylalanine (fMLP) or a combination of IL-5 and eotaxin. The expression of the adhesion-promoting molecule CD11b and the fMLP receptor were assessed by flow cytometry. Both the fMLP- and IL5/eotaxin-induced eosinophil transmigration capacity was significantly more efficient in neonates than in adults (p < 0.0001 and p < 0.0002, respectively). The fMLP-induced up-regulation of CD11b on eosinophils was significantly (p < 0.0003) higher in neonates compared with that in adults. We also assessed a significant (p < 0.0001) higher expression of the fMLP receptor on resting eosinophils in neonates compared with that in adults. The integrated impact of increased transmigration capacity, fMLP receptor expression, and CD11b expression on eosinophil by bacterial peptide fMLP suggests that neonatal eosinophils possess the potential to play an alternative role compared with eosinophils in adults.

CD11b Antigen↗
PubMed2005

Perinatal exposure to nicotine causes deficits associated with a loss of nicotinic receptor function.

We investigated the role played by beta2-containing neuronal nicotinic receptors [nicotinic acetylcholine receptors (nAChRs)] in mediating nicotine's side effects in the fetus and newborn. Pregnant WT and mutant mice lacking the beta2 nAChR subunit were implanted with osmotic minipumps that delivered either water or a controlled dose of nicotine. Subsequently, we compared the development of the sympathoadrenal system and breathing and arousal reflexes of offspring shortly after birth, a period of increased vulnerability to nicotine exposure. Newborn WT pups exposed to nicotine exhibited all of the deficits associated with maternal tobacco and nicotine use, and linked to poor neonatal outcome: growth restriction, unstable breathing, and impaired arousal and catecholamine biosynthesis. Remarkably similar deficits were detected in pups lacking beta2-containing nAChRs. Loss-of-function of these nAChRs consequently reproduces with astonishing fidelity many of the abnormalities caused by perinatal nicotine exposure. We propose that the underlying mechanisms of nicotine's detrimental side effects on a range of crucial defensive reflexes involve loss of function of nAChR subtypes, possibly via activity-dependent desensitization.

Animals↗
PubMed2005

Continuous feeding promotes gastrointestinal tolerance and growth in very low birth weight infants.

OBJECTIVE: To compare the effects of continuous versus intermittent feeding on gastrointestinal tolerance and growth in very low birth weight (VLBW) infants. STUDY DESIGN: In a randomized, controlled trial conducted at 3 neonatal units, 70 premature infants with a gestational age 24 to 29 weeks and birth weight < 1200 g were assigned to 1 of 3 feeding methods: continuous nasogastric feeding, intermittent nasogastric feeding, or intermittent orogastric feeding. Feeding was initiated within 30 hours of birth. Daily enteral and parenteral volumes, caloric and protein intakes, growth, enteral intolerance, and clinical complications were recorded. Cox regression analysis was used to determine primary outcome, the time to achieve full enteral feeding. RESULTS: The continuously fed infants achieved full enteral feeding significantly faster than the intermittently fed infants (hazard ratio [HR] = 1.86; 95% confidence interval [CI] = 1.07 to 3.22). In stratified analysis according to birth weight, the improvement was even more pronounced in the smallest infants, those with birth weight < or = 850 g (adjusted HR = 4.13; 95% CI = 1.48 to 11.53). Growth rate was significantly faster in the continuously fed infants ( P = .002). CONCLUSION: In VLBW infants, continuous feeding seems to be better than intermittent feeding with regard to gastrointestinal tolerance and growth.

Analysis of Variance↗
PubMed2005

Diffusion tensor imaging on teenagers, born at term with moderate hypoxic-ischemic encephalopathy.

Hypoxic-ischemic encephalopathy (HIE) is graded with three levels of severity-mild, moderate and severe. The outcome of individuals with mild and severe grades can be reliably predicted from this scheme. Individuals with moderate degree are divided in outcome between those who suffer major neurologic problems (e.g., cerebral palsy) and those who are assumed to recover from the incident. It is however not clear if the recovery is complete and unquestionable. A group of adolescents who had been born at term, diagnosed with moderate HIE but had not developed cerebral palsy, were investigated with diffusion tensor imaging. Fractional anisotropy maps were used as a basis of comparison to a group of controls of the same age and gender distribution. In several white matter areas fractional anisotrophy was lower in the group of individuals with a history of moderate HIE. These areas include the internal capsules (bilaterally in the posterior limb and on the right in the anterior limb), the posterior and anterior corpus callosum as well as frontal inferior white matter areas. These results indicate that even in the absence of such major neurologic impairments as cerebral palsy, moderate HIE causes long term white matter disturbances which are not repaired by adolescence.

Adolescent↗
PubMed2004

Hypoxic response in newborn rat is attenuated by neurokinin-1 receptor blockade.

Substance P (SP) is considered to be involved in the regulation of respiration, in particular when respiratory demands are increased, such as during hypoxic stress. In the present study we have investigated the effects of intracerebroventricular pre-treatment with the selective NK-1 receptor antagonist RP67580 on the respiratory response to hypoxia in 5-day-old rat pups. Basal respiration was not altered by RP67580. When subjected to hypoxia (10% O(2)), rat pups pre-treated with RP67580 were unable to sustain the increased respiratory frequency at 10 min. In situ hybridisation demonstrated increased expression of c-fos mRNA in several brainstem areas following hypoxia. This activation was blocked by the antagonist in the retrotrapezoid nucleus and the rostral ventrolateral medulla, areas known to be involved in the hypoxic ventilatory response. This study corroborates a role of endogenously released SP, mediated via NK-1 receptors, in the sustained response to hypoxia in 5-day-old rat pups and suggests that neurons in the rostral ventrolateral medulla are important in this function. It also represents a further example that neuropeptides are released under stressful conditions.

Analgesics↗
PubMed2004

Congenital hypoventilation and impaired hypoxic response in Nurr1 mutant mice.

Nurr1, a transcription factor belonging to the family of nuclear receptors, is expressed at high levels immediately after birth. Gene-targeted mice lacking Nurr1 fail to develop midbrain dopaminergic neurones and do not survive beyond 24 h after birth. Dopamine (DA) levels may be regulated by Nurr1, and as DA is involved in both central and peripheral respiratory control, we hypothesized that lack of Nurr1 may impair breathing and cause death by respiratory failure. We demonstrate herein that Nurr1 newborn knockout mice have a severely disturbed breathing pattern characterized by hypoventilation, numerous apnoeas and failure to increase breathing when challenged with hypoxia. In heterozygote Nurr1 mice the response to hypoxia is also altered. Furthermore, the central respiratory rhythm, generated from isolated brainstem-spinal cord preparations, exhibits impaired response to hypoxia in mice lacking Nurr1. Moreover, Nurr1 is expressed in several respiratory-related regions of the nervous system, including the nucleus of the solitary tract, the nucleus ambiguus and the dorsal motor nucleus of the vagus nerve, and in the carotid bodies. The prominent Nurr1 expression in these areas, involved in respiratory control, along with the severe respiratory phenotype, indicates that Nurr1 plays a major role in the extrauterine adaption of respiratory control and the response to hypoxia.

Animals↗
PubMed2004

Development of neurotransmitter systems during critical periods.

Neurotransmitters are released from neurons and mediate neuronal communication. Neuromodulators can also be released from other cells and influence the neuronal signaling. Both neurotransmitters and neuromodulators play an important role in the shaping and the wiring of the nervous system possibly during critical windows of the development. Monoamines are expressed in the very early embryo, at which stage the notochord already contains high noradrenaline levels. Purines and neuropeptides are probably also expressed at an early stage, in a similar way as they occur during early phylogenesis. The levels of most neurotransmitters and neuromodulators increase concomitantly with synapse formation. Some of them surge during the perinatal period (such as glutamate, catecholamines, and some neuropeptides) and then level off. The interesting question is to what extent the expression of neuroactive agents is related to the functional state of the fetus and the newborn. Monoamines are expressed in the very early embryo, at which stage the notochord already contains high noradrenaline levels. They may have an important role for neurotransmission in the fetus. In the adult mammal, the fast switching excitatory amino acids dominate. However, they also seem to be important for the wiring of the brain and the plasticity before birth. NMDA receptors that are supposed to mediate these effects dominate and are then substituted by AMPA receptors. The main inhibitory amino acids gamma-aminobutyric acid (GABA) and glycine are excitatory in the developing brain by depolarizing developing neurons that have high Cl- concentrations. This seems to be of major importance for the wiring of neuronal circuits. Prenatal or neonatal stress, for example, hypoxia, can affect the programming of neurotransmitter and receptor expression, which can lead to long-term behavioral effects.

Animals↗
PubMed2004

First line of defense in early human life.

Innate antimicrobial peptides are considered to play an important role in host defense against microbial invasion. They are expressed in a wide variety of organisms. In the case of human beings, defensins and the cathelicidin LL-37 appear to be the major microbicidal peptides. With respect to human neonates, only few investigations have been performed in this context, revealing the presence of alpha-defensins and LL-37 in neutrophils and vernix caseosa. In addition, beta-defensins are present in tracheal aspirates and breast milk, whereas LL-37 has been detected in the skin of the newborn baby. During recent years, immunomodulatory activities such as chemotaxis have emerged as important functions of antimicrobial peptides. Thus, these innate effectors may work synergistically to provide a first line of defense against infection, as well as to promote interactions between the innate and adaptive immunity in newborn infants.

Antimicrobial Cationic Peptides↗
PubMed2003

Preterm children have disturbances of white matter at 11 years of age as shown by diffusion tensor imaging.

Preterm birth frequently involves white matter injury and affects long-term neurologic and cognitive outcomes. Diffusion tensor imaging has been used to show that the white matter microstructure of newborn, preterm children is compromised in a regionally specific manner. However, until now it was not clear whether these lesions would persist and be detectible on long-term follow-up. Hence, we collected diffusion tensor imaging data on a 1.5-T scanner, and computed fractional anisotropy and coherence measures to compare the white matter integrity of children born preterm to that of control subjects. The subjects for the preterm group (10.9 +/- 0.29 y; n = 9; birth weight or= 2500; gestational age, >or= 37 wk). We found that the preterm group had lower fractional anisotropy values in the posterior corpus callosum and bilaterally in the internal capsules. In the posterior corpus callosum this difference in fractional anisotropy values may partially be related to a difference in white matter volume between the groups. An analysis of the coherence measure failed to indicate a group difference in the axonal organization. These results are in agreement with previous diffusion tensor imaging findings in newborn preterm children, and indicate that ex-preterm children with attention deficits have white matter disturbances that are not compensated for or repaired before 11 y of age.

Anisotropy↗
PubMed2003

IL-1 beta depresses respiration and anoxic survival via a prostaglandin-dependent pathway in neonatal rats.

IL-1 beta has been proposed to be an important mediator linking infection, apnea, and sudden infant death syndrome. We hypothesized that IL-1 beta acts in this capacity by depressing brainstem respiratory neurons via a prostaglandin-dependent pathway. For studying the effects of IL-1 beta on respiration as well as the mechanism underlying its actions, 7-d-old rats received an initial injection (i.p.) of NaCl or a cyclooxygenase inhibitor (indomethacin, 10 mg/kg) followed by a second injection (i.p.) at 30 min of NaCl, recombinant rat IL-1 beta (10 microg/kg), or lipopolysaccharide (LPS; 100 microg/kg). Respiration during normoxia and in response to anoxia (100% N2) was examined at 60 min after the second injection using flow and barometric plethysmography. Animals given IL-1 beta breathed more slowly and died more often after anoxia. LPS also reduced the rats' ability to autoresuscitate and survive an anoxic challenge. Indomethacin prevented the depressive effects during normoxia and the adverse effects on survival. For investigating drug-induced changes in central respiratory activity, IL- 1 beta (1.0 or 1.25 ng/mL) and prostaglandin E2 (5 or 20 microg/L) was applied to the brainstem-spinal cord preparation of 0- to 4-d-old rats. Whereas IL-1 beta exerted no effect on respiration measured at the C4 ventral root during a 60-min period, prostaglandin E2 reversibly inhibited respiratory activity. These findings suggest that IL-1 beta does not inhibit respiratory neurons directly but may depress breathing and hypoxic defense via a prostaglandin-mediated mechanism.

Animals↗