New Chance for Preemies

18. December 2006
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There is hope for babies suffering from brain damage caused by a periventricular Leukomalacia: Innsbruck neonatologists examine a possibility to remedy existing damage.

Periventricular Leukomalacia (PVL) is one of the most frequent reasons for neurological development disorders of premature infants. Here, primarily the white substance in the brain is damages. About 5 out of 100 newborns with a weight below 1.5 kilograms are diagnosed with PVL. The children develop the disease after birth, but reasons for it are mainly pre-natal conditions. Anoxia or inflammations can cause it. Up to now it was not possible to determine, when exactly the damage begins. That is the main reason why a prevention of damage is very limited.

The Babies suffer from severe consequences

The white substance in the brain contains motor nerve cells, enabling targeted movements. Caused by the damage in this area, the affected children have differently severe shortfalls of motor functions, which again depend on the occurrence of the changes. The palette goes from apraxia of the legs (diplegia) and arms, spasticity, to dysfunctions of cognitive functions or as far as the development of Epilepsy (West-Syndrome). In younger children, the periventricular Leukomalacia is diagnosed by ultrasound, in children the age of 24 months and older, Magnetic resonance imaging (MRI) is the first choice. It is next to impossible to predict the development of a child, the actual individual development cannot be foretold by anyone reputable.

Stimulation therapy is to repair damages

Up to now, now causal therapy is available for PVL, but a ray of light is showing on the horizon: The Innsbruck Neonatologist Dr. Matthias Keller has administered mice with bone marrow-stimulating substances and discovered the following: G-CSF (Granulocyte colony stimulating factor) and SCF (stem cell factor) supports the repair mechanisms of a premature infant. The substances are already being used in oncology. The human brain goes through its most intensive period of growth in the last third of the pregnancy and the few first months after birth. And during that time it is particularly plastic. This feature makes the different between a baby and an adult, which is the reason why those conclusions cannot be transferred to premature infants without second thought.

The Timing is essential for the success

But on the mouse model it shows: If G-SCF and SCF are administered to the premature infant immediately after the brain damaging, they have an ill effect. But given a few days later, they reduce the brain damage round about 30-50 percent. The stimulation of the child's own stem cell production by G-SCF and SCF seems to be more physiologic for the newborn than a therapy, where stem cells are hatched first and then are injected in the brain. Those realizations attune optimistic. But the regeneration of nerve cells is only a portion. Keller and his team will study now, whether the regenerated nerve cells have a normal neurological function as well, and are able to establish connections. He want to ensure, that this treatment method does not harm the further development of the premature infant. Keller also goes into the question, whether the child's own stem cells taken from the umbilical cord or especially prepared cells achieve even better results.

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