New Research Offers Clues To Prevent Brain Damage In Premature Babies

The research is published online today in Nature Medicine.

StephenA. Back, M.D., Ph.D., an Associate Professor of Pediatrics andNeurology at the Oregon Health & Science University School ofMedicine, Portland, and colleagues identified some of the key factorsthat prevent brain damage repair in premature babies and patients withmultiple sclerosis (MS) or certain other neurological diseases. Theirfindings offer important clues about why the nervous systems fails torepair itself and suggest that some forms of brain damage could bereversed.

Dr. Back, who studies developmental brain injury in premature infants,previously found a link between damage to white matter in the brainassociated with premature birth, and damage to immature cells in thebrain and spinal cord, called oligodendrocyte progenitors. These cellsnormally mature to become oligodendrocytes that make myelin (theinsulating sheath surrounding nerve fibers in the brain and spinalcord) throughout life. In some cases, these cells fail to mature andcannot repair damage to the white matter of the brain.

The white matter is made up of long nerve fibers wrapped in myelin.Different kinds of white matter injury cause cerebral palsy andlearning problems in children born prematurely, and MS in olderchildren and adults. Dr. Back and his colleagues found that hyaluronicacid (HA) prevent immature oligodendrocytes from maturing and coatingnerve fibers with new myelin. Astrocytes, the first-responders to nervedamage in the brain, produce HA, which accumulates on nerve fiberswhere myelin is missing.

"Preterm birth can interrupt the normal myelination process. Therefore,this report may help to explain the brain damage seen in prematurebabies, some of whom have cerebral palsy," said Michael Katz, M.D.,Senior Vice President for Research and Global Programs at the March ofDimes, which is supporting Dr. Back. "Until we find the answers topreventing prematurity, research such as this may lead us to new waysto prevent brain damage and has the potential to improve the lives ofthousands of infants."

Prematurity is the leading killer of America's newborns and hasincreased 29 percent since 1981. More than 470,000 babies are bornprematurely each year in the United States. Premature babies often dieor suffer lifelong consequences, including cerebral palsy, mentalretardation, chronic lung disease, blindness, and hearing loss.

According to research conducted by the National Institute ofChild Health and Human Development, 25 percent of extremely prematurebabies have neurological problems at 18 to 22 months, and 17 percentwill develop cerebral palsy.

"Hyaluronan Accumulates in Demyelinated Lesions and InhibitsOligodendrocyte Progenitor Maturation," published in the September 2005issue of Nature Medicine, volume 11, number 9, was a collaborativeeffort of Dr. Back, senior researcher Larry Sherman, Ph.D., an AdjunctAssociate Professor of Cell and Developmental Biology, OHSU School ofMedicine, and other colleagues at OHSU, the National Institutes ofHealth, and the Cleveland Clinic Foundation.

The March of Dimes is a national voluntary health agency whose missionis to improve the health of babies by preventing birth defects,premature birth and infant mortality. Founded in 1938, the March ofDimes funds programs of research, community services, education, andadvocacy to save babies and in 2003 launched a campaign to address theincreasing rate of premature birth.

For more information, visit the March of Dimes Web site at marchofdimes.com or its Spanish language Web site at nacersano.org.