Insufficient oxygen (hypoxia) and/or insufficient blood (ischemia) is a major cause of damage to the newborn infant’s brain: a hypoxic-ischemic injury. This injury can result in cerebral palsy, cognitive defects and/or seizures. At this time, there is no clinical intervention that can be recommended for infants to protect the threatened brain. A number of interventions have been developed in the past, but when evaluated have either been minimally successful in protecting the brain or the side effects have been unacceptable. The search continues for a safe and useful intervention that can be used in high risk infants for prevention at the time the injury is occurring or shortly thereafter.

Dr. Kara L. Arvin and her colleagues have found in animal studies that a well known antibiotic, minocycline, has been successful in newborn animals to protect against damage due to hypoxia-ischemia. The antibiotic has been used safely and effectively in adult humans for a long period of time in combating infection. In a carefully controlled study of newborn animals, the research team showed that minocycline given either immediately before or after the hypoxic-ischemic injury provides nearly complete neuro-protection. It appears to work by interfering with the cell mechanism causing metabolic death of the nerve cell (apoptosis). There were no adverse side effects of the treatment. On the basis of this successful animal experiment, the authors suggest that it is an attractive candidate for trial in human neonates.

Comment:

We agree. The foundation has made a research grant to this group to develop and initiate a protocol for evaluating the effectiveness in humans of this potentially important new approach to protecting the brain of the newborn at high risk of injury.