Every year, around 1,000 babies in the UK develop hypoxic-ischaemic encephalopathy (HIE), a condition resulting from a lack of oxygen and blood supply to the brain around the time of birth.[1,2] For newborn babies with moderate to severe HIE, the standard treatment – cooling therapy – improves their chances of survival and reduces the risk of long-term complications, but its benefits for mild HIE remain unclear. Dr Raymand Pang of University College London is carrying out laboratory research to explore whether melatonin or cooling therapy could also offer benefits for babies with mild HIE. His results could help pave the way for new treatment options for these vulnerable newborn babies in the future.
How are children’s lives affected now?
Babies with HIE who survive are at risk of lifelong disabilities, such as cerebral palsy, epilepsy, learning or behavioural difficulties, sight or hearing loss. Following HIE, there is a short but crucial window of opportunity to help limit brain injury.
“A treatment called cooling therapy, which involves lowering the baby’s body temperature for 72 hours shortly after birth, can help to improve outcomes for babies with moderate to severe HIE,” says Dr Pang.
Most newborn babies with mild HIE recover quickly without any treatment. However, research suggests that some may go on to develop problems, such as learning and behavioural challenges, later in childhood.
Currently, there are no proven treatment options available for babies with mild HIE.”
“Cooling therapy or melatonin – a hormone naturally produced by the body – are both promising candidates for limiting brain injury and its potential lasting effects. However, these options must first be assessed through laboratory studies before moving into clinical trials.”
How could this research help?
“Our long-term goal is to determine whether melatonin or cooling therapy could help protect the brain of newborn babies with mild HIE,” says Dr Pang.
Previous laboratory research has provided compelling evidence that melatonin after HIE may help limit brain injury by neutralising harmful molecules, preventing brain cell death, and reducing inflammation.
“We will now assess whether melatonin or cooling therapy can help reduce brain injury in a laboratory model of mild HIE, compared to no treatment,” says Dr Pang.
The researchers believe these experiments will show that melatonin and cooling therapy will offer similar benefits, providing vital evidence to support progressing melatonin into clinical trials for newborn babies with mild HIE.
If successful, melatonin could ultimately become an alternative to cooling therapy to help reduce the long-term impact of mild brain injury caused by oxygen deprivation around the time of birth on children’s lives.
Research table
Project details
| Project Leader | Dr Raymand Pang, MBChB PhD |
| Location | Institute for Women’s Health, University College London |
| Project Team |
Professor Nicola Robertson, MBChB PhD
Professor Joesph Standing, PhD |
| Other Locations | Institute of Child Health, University College London |
| Grant Awarded | |
| Grant Amount | £199,997 |
| Start Date | |
| End Date | |
| Duration | 12 months |
| Grant Code (GN number) | GN3068 |
References
- J.J. Kurinczuk, M. White-Koning, N. Badawi. Epidemiology of neonatal encephalopathy and hypoxic-ischaemic encephalopathy Early Hum Dev 86, 329-38 (2010).
- Office for National Statistics. Vital Statistics in the UK: births, deaths and marriages – 2023: https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/vitalstatisticspopulationandhealthreferencetables
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