Next step forward in treatments to reduce brain damage in babies
Action Medical Research has just announced funding of almost £200,000 into new research taking the next step forward with treatments which cool newborn babies to help to protect them from brain damage at birth.
This latest project follows on from previous investment of over £600,000 by children’s health charity, into key projects over the past 20 years which have helped to develop cooling as a new breakthrough therapy for babies. Now, researchers led by the Neonatology Department and Perinatal Brain Repair Group, University College London, are looking to take this pioneering method even further by researching how cooling can be combined with using drugs as an additional treatment.
The researchers believe that giving babies a sedative, called dexmedetomidine, might enhance the benefits of cooling. Evidence suggests this sedative can protect against the sort of brain damage that is caused by oxygen deprivation and a poor blood supply. The research team – led by Dr Nicola Robertson – will be investigating the benefits of adding this sedative to cooling in a laboratory model so they can assess the safety of the treatment and study how effective it is.
Cooling treatment is now used in hospitals and this breakthrough therapy is the product of a 20-year programme of research1 to which Action Medical Research contributed funding in the 1990s and 2000s. Ten years ago, vital research supported by the charity was conducted by Professor John Wyatt and colleagues at University College London. They carried out fundamental laboratory work on cooling and developed techniques for measuring brain temperature and for identifying babies that would potentially benefit from cooling. Their work was of central importance in the development of clinical trials of cooling in newborns.
Lack of oxygen or blood supply to the brain around the time of birth can be devastating and lead to brain injury in newborn infants. Worldwide it accounts for almost a million deaths a year2,3 . In the UK each year, more than 1,000 newborn babies are likely to lose their life or be permanently disabled after suffering brain injury due to oxygen shortage. Babies who live are at risk of disabilities like cerebral palsy, blindness, deafness, learning difficulties and epilepsy4.
The cooling treatment takes advantage of a therapeutic “window” that occurs after a newborn suffers oxygen shortage. By cooling the body (therapeutic hypothermia) to reduce brain temperature, doctors can alter the chemical processes that lead to brain damage. The baby is cooled with a purpose-made cap or a special blanket or mattress, then gradually warmed again.
In conjunction with the UCL team’s research, they participated in the international CoolCap trial, the first published major trial to show a benefit6. Over the last decade, the results from clinical trials have built up powerful evidence supporting the safety and efficacy of cooling7 so that the National Institute for Health and Clinical Excellence (NICE) has now published guidance supporting its use.
Yolande Harley, Deputy Director of Research, at Action Medical Research, said: “This groundbreaking treatment is now being increasingly offered both in the UK and other countries8. Here at Action Medical Research, we are celebrating our contribution to this pioneering therapy, which will have a lifelong impact on so many children.
“However, there is still much progress to be made and that is why we are delighted to announce today, that we are now funding the next stages of research to build on this pioneering therapy, looking at the benefits of combining cooling treatment with a sedative drug like dexmedetomidine, or with inhaled gases such as xenon, with the aim of further protecting babies from brain damage at birth.”
Notes to editors:
Other work already under way and funded by Action Medical Research to tackle brain damage in newborn babies includes:
- Two year study into hydrocephalus and brain haemorrhage in premature babies at Bristol University
- Two year study into brain damage at birth – preventing cerebral palsy, learning disabilities and epilepsy at Imperial College, London
- Three year study into preterm birth – developing a brain atlas, at Imperial College, London
- Three year study into cerebral palsy – how brain cells can die, at Imperial College, London
- Two year study into brain imaging in unborn babies to map connections within the developing brain, at Imperial College, London
For further information please contact:
Claudine Weeks, Communications Manager
Tel: 01403 327478
Action Medical Research is the leading UK-wide medical research charity dedicated to helping babies and children. We know that medical research can save and change children’s lives. For nearly 60 years we have been instrumental in significant medical breakthroughs, including the development of the UK polio vaccine and ultrasound scanning in pregnancy. Today, we continue to find and fund the very best medical research to help stop the suffering of babies and children caused by disease and disability. We want to make a difference in:
- tackling premature birth and treating sick and vulnerable babies
- helping children affected by disability, disabling conditions and infections
- targeting rare diseases that together severely affect many forgotten children.
- Edwards AD. The discovery of hypothermic neural rescue therapy for perinatal hypoxic-ischemic encephalopathy. Semin Pediatr Neurol. 2009 Dec;16(4):200-6.
- Lawn J, Shibuya K, Stein C. No cry at birth: global estimates of intrapartum stillbirths and intrapartum-related neonatal deaths. Bull World Health Organ. 2005 Jun;83(6):409-17.
- World Health Organization. The World Health Report 2005 - make every mother and child count. Chapter 5 (Newborns: no longer going unnoticed). 2005 (http://www.who.int/whr/2005/whr2005_en.pdf)].
- Zanelli SA, Stanley DP, Kaufman DA. Hypoxic-Ischemic Encephalopathy. eMedicine. Nov 2009 (http://emedicine.medscape.com/article/973501-overview).
- National Institute for Health and Clinical Excellence. Therapeutic hypothermia with intracorporeal temperature monitoring for hypoxic perinatal brain injury (Interventional procedure guidance 347). May 2010 (http://www.nice.org.uk/nicemedia/live/11315/48809/48809.pdf).
- Gluckman PD, Wyatt JS, Azzopardi D, Ballard R, Edwards AD, Ferriero DM, Polin RA, Robertson CM, Thoresen M, Whitelaw A, Gunn AJ. Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial. Lancet. 2005 Feb 19-25;365(9460):663-70.
- Edwards D, Brocklehurst P, Gunn A, Hailliday H, Juszczak E, Levene M, Strohm B, Thoresen M, Whitelaw A, Azzopardi D, Neurological outcomes at 18 months of age after moderate hypothermia for perinatal hypoxic ischaemic encephalopathy: synthesis and meta-analysis of trial data. BMJ 2010;340:c363
- Robertson NJ, Kendall GS, Thayyil S. Techniques for therapeutic hypothermia during transport and in hospital for perinatal asphyxial encephalopathy. Semin Fetal Neonatal Med. 2010 Apr 15. [Epub ahead of print].