Oxygen deficiency around birth is an important cause of brain damage in newborns. Early damage control can help prevent later problems. But current cooling treatment does not work well enough, causing about half of children to experience permanent motor problems, epilepsy or cognitive limitations. In previous studies, Jellema and his colleagues from the Pediatrics laboratory at Maastricht University showed that stem cell therapy has positive effects on brain development after oxygen deprivation around birth. Now he and his team will investigate whether it is better to administer the stem cells simultaneously with cooling or afterwards.
Cells in need
Brain damage caused by oxygen deficiency cannot usually be completely repaired, but treatment can prevent worse. Newborn babies are currently treated with body cooling: within six hours after birth, they are given a cooling pack for three days that reduces their body temperature to 33.5 degrees. “That cooling therapy works on brain cells in need,” Jellema explains. “The metabolism of these cells is disrupted, causing harmful substances to be released in the brain. Cooling therapy slows down the metabolism and prevents the accumulation of harmful substances, thus preventing further brain damage.”
The cells in distress send out alarm signals to which the body responds with a strong inflammatory response. Jellema: “The body tries to limit the damage, but unintentionally causes additional damage with an exaggerated inflammatory response. We know from previous research that stem cell therapy inhibits the body’s exaggerated response, thus protecting the brain.”
Jellema’s team works closely with researchers at the UMC Utrecht. “Research by our colleagues in Utrecht indicates that treating babies with brain damage with stem cells via a nasal spray is safe. A follow-up study will investigate whether babies who first receive cooling therapy and then stem cell therapy have less brain damage than children who only receive cooling therapy.” Although the treatments can be safely given one after the other, the effect of simultaneous application is still unclear. “Our fundamental research in Maastricht UMC+ shows that early treatment with stem cells may be even more effective. That is why we will first investigate in a sheep model whether the treatment effect can be enhanced if cooling and stem cells are given at the same time before we apply this strategy to babies.”
“Our research provides insight into the mechanisms of action of the therapy and the combination of treatments, because we can examine brain cells and study the changes at the cell level,” Jellema explains. “In addition, we will map the effects of the stem cells with advanced MRI techniques. This provides direction for further research in clinical practice. At the same time, the results of the clinical research provide follow-up questions for fundamental research. “By this continuous interaction between clinical and fundamental research and by involving the perspectives of parents and patients, we can together improve treatment for newborn babies with brain damage more quickly.”
Dr. Reint Jellema received a grant from the Brain Foundation for the Maastricht research and the Maastricht UMC+ awarded funding from the sector plan ‘accelerating health’. The research team also consists of Dr. Tim Wolfs and Dr. Daan Ophelders from the Pediatrics laboratory in Maastricht, Prof. Dr. Jeroen Vermeulen and Dr. Gerald Drenthen from Maastricht UMC+, Prof. Dr. Manon Benders and Dr. Cora Nijboer from the UMC Utrecht and patient associations Care4Neo and CP Netherlands.