Sickle cell disease: could an asthma medicine improve children’s intellectual abilities?

Around one in 2,000 babies born in the UK has sickle cell disease, an inherited blood disorder.¹ Some children with sickle cell disease have learning difficulties. The children are unusually susceptible to having strokes, which are known to cause learning difficulties, but Professor Fenella Kirkham, of University College London’s Institute of Child Health, believes breathing problems during sleep might also be partly to blame in some children. Professor Kirkham is investigating whether treatment with a commonly used asthma medicine, called Montelukast, improves children’s thinking ability, which could in turn boost their learning and performance at school.

How are children’s lives affected now?

Estimates suggest more than 12,500 people in the UK have sickle cell disease, an inherited disease that typically causes symptoms within months of birth.²

While many children with sickle cell disease have few symptoms and lead normal lives most of the time, they are vulnerable to serious problems including infections, anaemia and attacks of intense pain that can last for up to a week.

Children with sickle cell disease are also unusually susceptible to having strokes, which can lead to learning difficulties.

Some children with sickle cell disease also have a condition called sleep apnoea, which means they have night-time breathing problems that can disrupt sleep and affect concentration during the day. “We suspect that sleep apnoea may add to children’s learning difficulties if they’ve suffered a stroke says Professor Kirkham. “Sleep apnoea might also lead to learning difficulties even if children haven’t had a stroke. It’s important to investigate this further if we are to help children to achieve their full potential at school.”

How could this research help?

The researchers are investigating whether a commonly used asthma medicine, called Montelukast, improves the thinking abilities of children with sickle cell disease who sleep apnoea. Around 180 children between three and eight years old are taking part in a clinical trial of Montelukast treatment.

“Current treatment options for young children with sickle cell disease who have sleep apnoea include a ‘wait and see’ approach and operations to remove tonsils and/or adenoids,” says Professor Kirkham.

“Our work will provide evidence on an alternative, early treatment option,” adds Professor Kirkham. “Research already suggests that the asthma medicine Montelukast benefits children without sickle cell disease who have sleep apnoea,” adds Professor Kirkham. “If this medicine helps children with sickle cell disease too, it might mean fewer children need surgery, which is something parents worry about. It might also improve the overall health and learning abilities of children with sickle cell disease.”

References

1. NHS Choices. Newborn blood spot test. http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/newborn-blood-spot... Website accessed 28 July 2016.

2. Public Health England. Screening for sickle cell and thalassaemia. http://cpd.screening.nhs.uk/induction-resource/sct Website accessed 28 July 2016.