The trophic factors are made up of proteins containing
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Several trophic factors are synthesized by neurons and other parenchymal cells and are critical to cellular maintenance and regeneration. Nerve growth factor,238 brain-derived neurotrophic factor,239 and neurotrophin-3240 have all been shown to be neuroprotective in models of neonatal hypoxia ischemia. Many others, including vascular endothelial growth factor, have been found to be upregulated after cerebral ischemia.241 Recently, D'Cruz et al242 found that hypothermia increases brain-derived neurotrophic factor after asphyxial cardiac arrest in adult rats, and this increase implies enhancement of trophic factors as one possible mechanism behind the protective effects of hypothermia seen in this model. Several of these trophic factors are now commercially available. Augmentation of neuronal regeneration either through trophic factor replacement or augmentation by other means after cardiopulmonary arrest is an unexplored area for future research.
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