Brain injury at birth: could a new treatment called mitochondrial transplantation help protect brain cells from damage?

Every year, it’s estimated that around 1,000 babies in the UK will experience a brain injury called hypoxic-ischaemic encephalopathy (HIE) after being starved of oxygen around the time of birth.[1,2] The standard treatment is cooling therapy, which involves lowering a baby’s temperature shortly after birth. For many babies, this improves their chance of survival and reduces the risk of lifelong disabilities. But sadly, it doesn’t work for all. Dr Claire Thornton of the Royal Veterinary College (RVC), along with her colleagues at the RVC and King’s College London, is investigating if a new treatment called mitochondrial transplantation could also help protect brain cells from dying – improving the outlook for more babies with HIE.

How are children’s lives affected now?

Birth asphyxia – a lack of oxygen and/or a reduced blood supply to babies’ brains around the time of birth – can have terrible consequences, including a brain injury called hypoxic-ischaemic encephalopathy (HIE).

“Tragically, babies with this condition can lose their lives and those who survive can be left with long-term complications, such as cerebral palsy,” says Dr Thornton.

Following a brain injury, there is a delay before brain cells die, giving doctors an opportunity to use treatments that can provide protection. Currently, cooling therapy is the only available treatment for newborn babies with HIE – which involves deliberately lowering their temperature for three days within six hours after birth.

“Cooling therapy gives many babies a better chance of surviving and escaping disability – but unfortunately, it doesn’t save or protect the brain in all babies,” says Dr Thornton.

New treatments are urgently needed that can work alongside cooling to help improve outcomes for more babies with HIE.

How could this research help?

“Our ultimate goal is to develop an effective new treatment that, together with cooling therapy, can boost brain protection for newborn babies with HIE,” says Dr Thornton.

Researchers have discovered that HIE causes damage to tiny structures inside cells called mitochondria that generate energy. A new treatment called mitochondrial transplantation is showing promise in babies with a different condition.

“We will investigate if this novel approach, which involves replacing the damaged mitochondria with healthy ones, can better equip brain cells to survive,” says Dr Thornton.

The team will carry out laboratory experiments to identify the best dose and delivery route for getting healthy mitochondria into brain cells – and to explore if the approach is effective at preventing brain cell death.

“We hope that our work will one day lead to a new treatment for HIE which, when used in combination with cooling, could help save even more babies from the devastating effects of brain injury at birth,” says Dr Thornton.

References

1. J.J. Kurinczuk, M. White-Koning, N. Badawi. Epidemiology of neonatal encephalopathy and hypoxic-ischaemic encephalopathy Early Hum Dev 86, 329-38 (2010).
2. Office for National Statistics. Vital Statistics in the UK: births, deaths and marriages – 2018 update: https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/datasets/vitalstatisticspopulationandhealthreferencetables

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