Dr Claudia Nold |
The researchers, led by Associate Professor Marcel Nold and
Dr Claudia Nold together with senior scientist Dr Ina Rudloff at The Ritchie
Centre showed that an anti-inflammatory drug, interleukin 1 receptor antagonist
(IL-1Ra), could be given as a preventative measure in the hours after birth to
prevent the development of BPD.
The findings of the study have just been published in the Journal
of Cellular and Molecular Medicine.
A common preterm disease without a cure
Newborn babies’ immature lungs are often unable to cope with
the essential and life-saving respiratory support they are placed on in
hospital.
Up to 60 per cent of preterm babies develop BPD, an
inflammatory lung disease that causes severe injury to the lung tissue and prevents
normal lung growth, soon after birth. The more premature a baby is at birth,
the higher the risk of BPD. There is currently no safe and effective treatment.
BPD affects the alveoli, the tiny sacs in the lungs that
enable the entry of oxygen into the bloodstream, and the clearance of carbon dioxide
from the body.
Babies with BPD often suffer lifelong, severe, complications,
including impaired neurodevelopment, and are highly susceptible to airway
infections that may lead to death. As a
result, some of these babies and their families will require ongoing medical
care into childhood, some even into adulthood.
Timing is key
Previously, the Nolds’ laboratory showed that the anti-inflammatory drug IL-1Ra, currently used in diseases such
as rheumatoid arthritis, was effective in preventing BPD. Here, they
investigated optimal dose and timing for starting IL-1Ra treatment. IL-1Ra was
shown to be most effective at protecting newborns against BPD when given at
moderate doses and when started early, ideally within 12 hours of delivery.
“We found that IL-1Ra works best to prevent the development
of BPD when it is given immediately after birth, before BPD can kick in and establish itself, and at a lower, rather than higher,
dosage,” Dr Nold said.
The team also investigated the
potential of protein C, which is currently used mainly as a medication to
prevent blood clotting, to prevent BPD from developing.
“The two drugs act in different ways,
meaning there might be benefit in using them together to complement one another,”
Dr Nold said.
The drugs target distinct
pro-inflammatory responses that cause BPD, which prevents the disease from
forming, the study showed.
Well-tolerated, established drugs
“Both drugs are well tolerated and are shown to be safe in
children, so it appears likely that they could be safe to use in preterm babies
as well. This will have to be shown by clinical trials, which we hope can begin
soon,” Dr Rudloff said.
“Our findings may pave the way for a preventive treatment
for BPD that could be given to premature babies at highest risk of developing
the disease.”
The safety profiles of IL-1Ra and protein C are markedly
more favourable than those of corticosteroids, which are currently the only
drugs available to treat (but not prevent) BPD.
“We are very hopeful that alone or in combination, IL-1Ra
and protein C could one day be introduced as a safe therapy for at-risk
premature infants,” Dr Nold said.
“With no safe or effective treatment for these babies, this work
provides families with new hope and a healthier lifelong outlook.”
Quick
facts
·
Almost 1 in 10 babies in
Australia are born premature.
·
Up to 60 per cent of preterm
babies will develop BPD.
·
The anti-inflammatory drug
IL-1Ra has been used safely by more than 150 000 patients since its
introduction to clinical medicine in 1993.
|
How does IL-1Ra work?
IL-1Ra is a natural protein and is
the inhibitor of IL-1, one of the most important inflammatory cytokines. The
body uses IL-1Ra to curb excessive inflammation. In some diseases that involve chronic
inflammation such as rheumatoid arthritis, the patient often does not produce enough
IL-1Ra, and in these cases the IL-1Ra can be used to supplement the body’s
natural stores and act as an anti-inflammatory drug.
Next steps
Before they can commence a first-in-human trial of the drug
in premature babies, the team must undertake an important preclinical study.
Donations are urgently needed to support this important study.
To make a tax-deductible donation, please visit:
http://hudson.org.au/donate-now/.
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