A treatment already being trialled to reduce the impacts of perinatal inflammation on the newborn brain appears to be more effective than first thought.
Scientists at Hudson Institute of Medical Research, working with Monash University and Monash Health, have been trialling the anti-inflammatory drug anakinra to restore healthy brain development in babies at high risk of conditions such as cerebral palsy.
Dr Rob Galinsky, Head of the Perinatal Inflammation and Neurophysiology Laboratory, says it's been known for a long time that exposure to inflammation at or around the time of birth is strongly linked to the development of cerebral palsy.
"For several years we have been working on blocking a key inflammatory pathway in the brain, using anakinra, to maintain healthy brain development and function, and the results have been promising," Dr Galinsky said. "…but our latest pre-clinical research (published in Neuropharmacology) suggests that the beneficial effects could go way beyond what we first expected."
"Using a combination of molecular biology and measures of brain structure and function in our pre-clinical model, we've now shown that anakinra rescues growth and function of neuronal connections ('the wiring') in the part of the brain responsible for movement, sensation and cognition."
Anakinra restoring development of newborn brain circuits
"This latest research shows that anakinra is restoring the development of brain circuits that are essential for healthy brain function," he said.
Lead author Dr Sharmony Kelly says this research identifies much wider benefits in protecting fragile newborn brains.
"Previously our understanding of anakinra's neuroprotective effects were limited to the cells in the brain that make myelin," she said. "But this work tells us the restorative effects extend to improving the development of neuronal connections and their function."
"That means it doesn't just reduce brain inflammation, it protects how the perinatal brain wires itself, preserving both neuronal structure and function after inflammatory injury.
"Overall, the study strengthens anakinra's potential as a targeted neuroprotective therapy in perinatal medicine," Dr Kelly said.
What is anakinra?
Anakinra is an FDA-approved drug that's already used for inflammatory diseases in older children and adults.
In 2021, Dr Galinksky, together with Hudson Institute Professors Claudia and Marcel Nold and Professor Rod Hunt from Monash Newborn, began a clinical trial of anakinra at Monash Children's Hospital neonatal unit in very premature babies who are at risk of brain injury.
Anakinra was chosen for the trial because of its potential to control dangerous inflammation, following research by the team that identified the cellular and physiological pathways which underpin how this inflammation impairs brain cell development and function.
Their work continues in this area and now includes representatives from Monash Inst Pharmaceutical Science and Starship Children's Hospital/University of Auckland.
Baby Max was the first participant in the anakinra trial, and you can find out more about his story in this video about Hudson Institute's preterm birth research.
This clinical trial is now in its second phase of safety testing and funding is required to progress it to the efficacy stage, though preliminary results have been extremely promising.
