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Background  Germinal matrix hemorrhage ( GMH ) is a leading cause of mortality and lifelong morbidity in preterm infants. Posthemorrhagic hydrocephalus ( PHH ) is a common complication of  GMH . A sodium‐coupled bicarbonate exchanger ( NCBE ) encoded by solute carrier family 4 member 10 gene is expressed on the choroid plexus basolateral membrane and may play a role in cerebrospinal fluid production and the development of  PHH . Following  GMH , iron degraded from hemoglobin has been linked to  PHH . Choroid plexus epithelial cells also contain iron‐responsive element‐binding proteins ( IRP s),  IRP 1, and  IRP 2 that bind to  mRNA  iron‐responsive elements. The present study aims to resolve the following issues: (1) whether the expression of  NCBE  is regulated by  IRP s; (2) whether  NCBE  regulates the formation of  GMH ‐induced hydrocephalus; and (3) whether inhibition of  NCBE  reduces  PHH  development.    Methods and Results   GMH  model was established in P7 rat pups by injecting bacterial collagenase into the right ganglionic eminence. Another group received iron trichloride injections instead of collagenase. Deferoxamine was administered intraperitoneally for 3 consecutive days after  GMH /iron trichloride. Solute carrier family 4 member 10 small interfering RNA or scrambled small interfering RNA was administered by intracerebroventricular injection 24 hours before  GMH  and followed with an injection every 7 days over 21 days.  NCBE  expression increased while  IRP 2 expression decreased after  GMH /iron trichloride. Deferoxamine ameliorated both the  GMH ‐induced and iron trichloride–induced decrease of  IRP 2 and decreased  NCBE  expressions. Deferoxamine and solute carrier family 4 member 10 small interfering RNA improved cognitive and motor functions at 21 to 28 days post  GMH  and reduced cerebrospinal fluid production as well as the degree of hydrocephalus at 28 days after  GMH .    Conclusions  Targeting iron‐induced overexpression of  NCBE  may be a translatable therapeutic strategy for the treatment of  PHH  following  GMH .

journal of the american heart association

Targeting Germinal Matrix Hemorrhage–Induced Overexpression of Sodium‐Coupled Bicarbonate Exchanger Reduces Posthemorrhagic Hydrocephalus Formation in Neonatal Rats