Caius PhD student Tess Garrud and her supervisor, Caius Director of Studies in Medicine Professor Dino Giussani have suggested that subtle changes to the drugs administered to mothers threatened with preterm birth or to premature babies could further improve clinical treatment and help increase their safety.

One in ten babies is born prematurely and up to three-quarters of these are at significant risk of death or long-term illness because premature babies are born with immature lungs and hence are at risk of dying from respiratory problems.

Currently, every mother at risk of preterm birth gets treated with glucocorticoids – a treatment that is based on research, which discovered the important role played by these hormones in fetal development, specifically the administration of synthetic glucocorticoids which could accelerate the development of premature babies’ lungs and respiratory system.

“The evidence supporting the life-saving benefits of glucocorticoid treatment for premature babies is overwhelming. Without it, preterm babies would mostly die or suffer significantly from conditions associated with prematurity, leaving them with significant disability,” said Professor Giussani.

“Unfortunately, there can be subtle long-term adverse effects from the therapy that suggest we need to fine-tune current clinical therapy to maintain its beneficial effects but weed out any potential negative adverse effects later in life.”

Tess and Professor Giussani’s new findings, published in the journal Trends in Endocrinology and Metabolism, propose that a combination of glucocorticoid and specific antioxidants could be the solution to adverse effects from the usual therapy, making it safer for premature babies.

In their article, the Caians point to one likely culprit mechanism being the capacity of synthetic glucocorticoids to induce what is so-called ‘oxidative stress’, caused by an imbalance in the body of unstable molecules known as free radicals. While the body needs a certain number of free radicals for cell signalling or to stimulate repair, an overabundance can cause tissue and organ damage. Oxidative stress has been shown to lead to restricted blood flow and can damage the cardiovascular system in the long-term.

“When we bring together the research out there on this issue, we find strong evidence to suggest that combined antioxidant and glucocorticoid therapy may be safer than glucocorticoid therapy alone for the safer treatment of preterm birth,” said Tess.

Professor Giussani adds, “We believe it is time to study these further potential benefits of combined treatment in clinical trials. Glucocorticoid therapy is clearly a life-saver and is here to stay, but we support that treatment could be improved even further to maintain benefits while improving safety.” 

Professor Giussani holds a Caius Professorial Fellowship, he is The College Lecturer in Medicine '1958' as well as being Director of Studies in Medicine.  Within the University, he is The Professor of Developmental Cardiovascular Physiology & Medicine in the Department of Physiology Development & Neuroscience.  His research programmes are mostly funded by The British Heart Foundation.  Tess Garrud is a PhD student sponsored by The Wellcome Trust.

Adapted from a press release by the University of Cambridge.

Read the full article in Trends in Endocrinology and Metabolism.