Congenital Infection Influence on Early Brain Development Through the Gut-Brain Axis

STORCH Brazil: multicenter cohort study protocol to investigate neurodevelopmental paths and functioning in infants exposed to STORCH in Brazil

BACKGROUND

The acronym STORCH encompasses gestational infections that can lead to congenital syndromes or adverse neurological outcomes in children. In Brazil and worldwide, there has been an alarming increase in confirmed cases of STORCH in recent years. However, no study has examined the impact of STORCH on infants' neurodevelopmental outcomes in a large, multi-center cohort, recruiting a substantial number of participants, with analysis across a broad set of variables and ages and based on the International Classification of Functioning, Disability and Health (ICF) model.

OBJECTIVE

To examine the association between the exposure to classic STORCH (syphilis, toxoplasmosis, rubella, cytomegalovirus infection, and herpes simplex) on components of functioning in infants from 3 to 24 months old in Brazil.

METHODS

We propose a multi-center prospective cohort study that includes data collection in at least one city from each geographical region of Brazil. A proposed total sample size of 296 infants will be included at 3 months (12-15 weeks post term). They will be equitably divided into: (a) an exposed group (n = 148), consisting of those diagnosed with any congenital STORCH infection or whose mothers experienced prenatal STORCH infection; (b) an unexposed group (n = 148). Assessments are carried out longitudinally at 3, 6, 9, 12, 18, and 24 months of age. Assessment tools include Prechtl's General Movements Assessment, Hammersmith Infant Neurological Examination, Alberta Infant Motor Scale; Bayley Scales of Infant and Toddler Development; Survey of Well-being of Young Children; Autism Observational Scale for Infants; Modified Checklist for Autism in Toddlers; Child Behavior Checklist; and Young Children's Participation and Environment Measure. Descriptive analyses, including the calculation of relative risk, and logistic regressions will be conducted to examine the association between gestational exposure to STORCH agents and infants' responses/outcomes.

DISCUSSION

The STORCH Brazil study will investigate the impact of STORCH exposure on functioning, including neurodevelopmental trajectories, in infants during their first two years, aligning with the ICF framework. This will enhance understanding of the characteristics and needs of STORCH-exposed infants, aiding therapists in making informed clinical decisions. The results might support public policies tailored to this population. Findings will be disseminated to ensure knowledge translation.

CLINICAL TRIAL NUMBER

Not applicable.

Research Progress on the Role of the Interleukin Family in the Pathogenesis of Cerebral Palsy in Children

Cerebral palsy (CP), a common neurological disorder in children, remains a significant research focus. The interleukin (IL) family, pivotal mediators in inflammatory responses, shows increased expression in various neuroinflammatory diseases, markedly influencing their onset and progression. Elevated IL levels in the brains of children with CP, in contrast to healthy peers, reflect similar elevations in neurological conditions linked to CP, indicating a strong association between CP and the IL family. Anti-inflammatory therapies, particularly those targeting ILs, have shown effectiveness in animal models, diverging from traditional CP management methods. This shift suggests IL modulation as a promising therapeutic strategy in pediatric CP. This review consolidates recent findings on the IL family's role in CP, illuminating their evolving relationship.

Treatment of preterm brain injury via gut-microbiota-metabolite-brain axis

BACKGROUND

Brain injury in preterm infants potentially disrupts critical structural and functional connective networks in the brain. It is a major cause of neurological sequelae and developmental deficits in preterm infants. Interesting findings suggest that the gut microbiota (GM) and their metabolites contribute to the programming of the central nervous system (CNS) during developmental stages and may exert structural and functional effects throughout the lifespan.

AIM

To summarize the existing knowledge of the potential mechanisms related to immune, endocrine, neural, and blood-brain barrier (BBB) mediated by GM and its metabolites in neural development and function.

METHODS

We review the recent literature and included 150 articles to summarize the mechanisms through which GM and their metabolites work on the nervous system. Potential health benefits and challenges of relevant treatments are also discussed.

RESULTS

This review discusses the direct and indirect ways through which the GM may act on the nervous system. Treatment of preterm brain injury with GM or related derivatives, including probiotics, prebiotics, synbiotics, dietary interventions, and fecal transplants are also included.

CONCLUSION

This review summarizes mechanisms underlying microbiota-gut-brain axis and novel therapeutic opportunities for neurological sequelae in preterm infants. Optimizing the initial colonization and microbiota development in preterm infants may represent a novel therapy to promote brain development and reduce long-term sequelae.

Gut Microbiome and Neurodevelopmental Disorders: A Link Yet to Be Disclosed

Τhe importance of the gut microbiome and its functions has only recently been recognized and researched in greater depth. The establishment of the human gut microbiome begins in utero, forming its adult-like phenotype in the first 2-3 years of life. Several factors affect and alter the gut microbiome composition and its metabolic functions, such as early onset of breastfeeding, mode of delivery, antibiotic administration, or exposure to chemical substances, among others. Existing data support the important connection between health status and gut microbiome homeostasis. In cases when this balance is disturbed, several disorders may arise, such as inflammatory reactions that lead to atopy, eczema, or allergic asthma. The so-called gut-brain axis refers to the complex biochemical pathways between the central nervous system and the gastrointestinal system. One of the most fascinating areas of ongoing research is the broad spectrum of neurodevelopmental disorders (NDDs) and how gut health may be associated with such disorders. The prevalence of NDDs, such as autism spectrum disorder or attention deficit hyperactivity disorder, has increased over recent years. Whether gut microbiota homeostasis plays a role in these disorders is not yet fully understood. The aim of this narrative review is to provide an account of current knowledge on how gut health is linked with these disorders. We performed a literature review in order to identify and synthesize available data that highlights the potential association between NDDs and a balanced gut microbiome in terms of composition and proper function. The connection between the gut microbiome and NDDs offers promising new opportunities for future research.