The role of prostaglandin receptors in regulating cerebral blood flow in the perinatal period.

Prostaglandins exert significant effects on the range of cerebral blood flow autoregulation. However, the newborn exhibits a narrow cerebral blood flow autoregulatory range compared to the adult, and this apparently contributes to the susceptibility of the newborn to major perinatal complications such as intraventricular cerebral haemorrhage. Reduced vasoconstriction in response to prostaglandins due to the fewer prostaglandin receptors, especially for PGE2 (EP) and PGF2 alpha (FP), seems to contribute in part to the narrower range of cerebral blood flow autoregulation in the newborn. Evidence suggests that high levels of prostaglandins in the perinatal period are responsible for the down-regulation of neurovascular EP and FP receptors. We review the pharmacology of prostaglandin receptors, in particular PGE2 and PGF2 alpha receptors, their ontogeny on the neural vasculature, the perinatal regulation of their expression, and how these changes relate to the control of neural blood flow autoregulation.