Approximately 10 percent of infants born prematurely at 8 weeks are susceptible to developing cerebral palsy due to infections. This can inflict damage upon nerve fibers that are found deep within the brain. Despite the absence of a current remedy to avert this outcome, recent experiments involving neonatal mice have unveiled a potential pathway for intervention.
Scientists at Duke Health located in North Carolina have successfully pinpointed a specific fatty molecule present in breast milk. This molecule acts as a catalyst, initiating a transformative process where the stem cells within the brain can generate fresh white matter. Astonishingly, this process demonstrates the capability to “reverse the injury” that’s caused by the aforementioned infections.
Heading this research is Assistant Professor Eric Benner, M.D., Ph.D., affiliated with the Department of Pediatrics at Duke University School of Medicine. As the lead author of the study, Professor Benner lauds this discovery as highly promising and brimming with potential.
“The fact that this molecule is already found in something that is safe for premature babies–breast milk–is extremely encouraging,” Benner explained.
The beneficial effects of fats present in breast milk on a child’s brain development have already been established. However, it’s important to note that there are various kinds of fats. This research has successfully pinpointed a specific lipid molecule within breast milk that plays a crucial role in enhancing the development of white matter in the brain.
“Now, we can begin to develop a therapy that isolates and delivers this lipid in a way that is safe for the unique challenges of these infants,” said Benner, one of the co-founders of Tellus Therapeutics. This is a Duke spinout company that was made to bring this therapy done outside and from homes into the neonatal intensive care unit.
An upcoming clinical trial is set to administer a specific fatty molecule intravenously to patients. This approach has been chosen due to the presence of gastrointestinal issues in many infants within this vulnerable population, which makes it unsafe to provide them with milk or medication orally.
The findings of a recent study, published in the journal Cell Stem Cell earlier this week, shed light on the mechanism of action. The identified lipid molecule has the remarkable ability to traverse the blood-brain barrier and establish a connection with the stem cells residing in the brain. Upon interaction, these stem cells are stimulated to differentiate into a particular cell type known as oligodendrocytes.
In essence, oligodendrocytes play a pivotal role akin to a central hub, facilitating the production of white matter in the central nervous system. This is especially crucial in the context of pre-term infants. The production of this white matter through the action of the administered lipid molecule serves as a protective shield, thwarting the potential for neurological damage that would otherwise severely affect the child’s motor abilities. This safeguarding action holds the key to preventing the developmental hindrances characteristic of cerebral palsy.
The upcoming clinical trial’s innovative approach of intravenously administering the fatty molecule addresses the unique challenges posed by gastrointestinal issues in vulnerable infants. The insights from the recent study elucidate how this lipid molecule influences brain stem cells, prompting the formation of oligodendrocytes that, in turn, orchestrate the creation of protective white matter. Ultimately, this intervention could revolutionize the prevention of neurological impairment and developmental limitations associated with conditions like cerebral palsy.
“The timing of brain injury is extremely difficult to predict, thus a treatment that could be safely given to all preterm babies at risk would be revolutionary,” said Agnes Chao, M.D. She is a former fellow in the Division of Neonatology and first author of the paper.
“As a neonatologist, I’m so excited that I may be able to offer a treatment to families with babies that are affected by preterm brain injury who would otherwise have no other options,” Chao added.
The funding for the study came from various sources, including the National Institutes of Health.
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