Brain haemorrhages in premature babies: new lab model for better treatments
This research was completed on 31 March 2011
Published on 6 October 2007
Bleeds into the fluid-filled spaces (the ventricles) in the brain are a significant cause of death and illness in premature babies,1 often leading to lifelong problems such as cerebral palsy, learning disabilities, seizures and hydrocephalus (water on the brain). Professor Marianne Thoresen, of the University of Bristol, has developed a new laboratory model, which mimics what happens after a large bleed in the brain. She believes the model will facilitate the development of new treatments.
What is the problem and who does it affect?
Up to one in four premature babies whose birth weight is very low suffers a haemorrhage – a bleed – in the fluid-filled spaces in the brain (the ventricles).2 The smaller and more premature the baby, the higher the risk of a bleed.
Currently, there is no way to stop this bleeding, which can have serious consequences. “Babies who suffer large bleeds can develop lifelong problems including cerebral palsy, learning disabilities, epilepsy, blindness and deafness,” explains Professor Thoresen. “Sadly, some lose their lives.”
Large bleeds also put babies at risk of developing persistent hydrocephalus, also known as ‘water on the brain’. “The main way to help babies with persistent hydrocephalus is to operate on them to insert a shunt – a thin tube that diverts fluid from the ventricles to the baby’s abdomen,” explains Professor Thoresen. “However, in such tiny babies, shunts often get infected or fail. Even if shunts are successful, most babies remain dependent them for the rest of their lives. No treatment has yet been shown to be entirely effective.”
There is an urgent need for better ways to help babies who have suffered these bleeds in the brain.
What did the project achieve?
Before starting this project, Professor Thoresen had already developed a small laboratory model that mimics what happens after newborn babies suffer a bleed in the brain. The model, which was refined during this project, is now highly suited to drug screening (testing whether possible new treatments show promise).3
“In this project, we investigated the effects of five drugs using our small laboratory model,” says Professor Thoresen.4 “Unfortunately, none proved effective. This is the nature of research: sometimes the treatment one proposes is ineffective.”
Another part of this project was much more successful. “We have developed a larger laboratory model, which mimics even more closely what happens after newborn babies suffer brain haemorrhages,” explains Professor Thoresen. “This model will facilitate the development of new treatments – enabling us to study the disease processes that take place after bleeds in the brain, investigate how well potential new drugs might work, and assess new diagnostic techniques. Testing new treatments in a larger model like this is important before starting clinical trials in babies.”
An effective new treatment for babies who’ve suffered a bleed in the brain could help save babies’ lives, stop them from needing operations to insert shunts, and spare them from disability.
What are the researchers’ credentials?
Professor Thoresen is a leading expert in developing ways to protect the newborn brain from injury. She led pioneering research that showed that cooling babies after they’ve suffered oxygen deprivation can protect the brain and improve outcomes. Cooling was tested in small, then larger models, and then in clinical trials in babies, before becoming part of routine practice.
|Project Leader||Professor M Thoresen MD PhD FRCPCH|
|Location||Department of Child Health, Clinical Science at South Bristol, Bristol University|
|Grant awarded||6 July 2007|
|Start date||1 March 2008|
|End date||31 March 2011|
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1. Patient.co.uk. Infantile intraventricular haemorrhage. http://www.patient.info/doctor/Infantile-Intraventricular-Haemorrhage.htm Website accessed 18 June 2012.
2. McCrea HJ, Ment, LR. The Diagnosis, Management and Postnatal Prevention of Intraventricular Hemorrhage in the Preterm Neonate. Clin Perinatol 2008 ; 35(4): 777–vii. doi:10.1016/j.clp.2008.07.014. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901530/pdf/nihms-83885.pdf
3. Aquilina K, et al. Neonatal rat model of intraventricular haemorrhage and post-haemorrhagic ventricular dilatation with long-term survival into adulthood. Neuropathology and Applied Neurobiology 2011; 37 (2): 156-65.
4. Hoque N, et al. Decorin and colchicine as potential treatments for post-haemorrhagic ventricular dilatation in a neonatal rat model. Neonatology 2011; 100(3): 271-6.