Glucocorticoids Could Decrease Brain Injury Caused by Oxygen Deprivation at Birth

Glucocorticoids could help preserve the structure and function of nerve cells when given after oxygen deprivation at birth, a possible cause of cerebral palsy, a study published in the International Journal of Molecular Sciences suggests. This neuroprotective effect may be more pronounced when the glucocorticoids are given in cases of additional inflammatory injury, such as bacterial blood infection, or sepsis in the newborn.

For the study titled “Glucocorticoids Protect Neonatal Rat Brain in Model of Hypoxic-Ischemic Encephalopathy (HIE),” a team of researchers led by Lubo Zhang, PhD, of the Center for Perinatal Biology at Loma Linda University School of Medicine in California, investigated the effect of two glucocorticoids, dexamethasone and hydrocortisone treatment, given after oxygen deprivation at birth in a rat model. The researchers also examined the effect of hydrocortisone treatment on brain injury caused by oxygen deprivation at birth coupled with sepsis.

They found that dexamethasone significantly reduced the size of brain tissue necrosis or death in the rats when directly injected into the brain, but did not have any effects when given through the nose.

Hydrocortisone also significantly reduced the size of the brain tissue death when given via direct brain injection. Moreover, administration via the nose at a dose of 300 µg also was protective against brain injury, but in male rats only.

Finally, the researchers found that sepsis significantly increased the size of brain tissue death, and hydrocortisone treatment following sepsis significantly decreased the size of brain tissue death regardless of the administration method.

Importantly, hydrocortisone given via the nose effectively decreases brain injury in newborn rats with brain injuries caused by oxygen deprivation at birth and complicated by sepsis. That is a common occurrence in newborn babies who had oxygen deprivation at birth.

“The present study provides experimental evidence that glucocorticoids given after HI [hypoxic-ischemic] injury have a promising therapeutic effect of neuroprotection in a rat model” the team concluded in its report.

According to the authors, more research is needed to understand how glucocorticoids protect the newborn brain from injury, and to explore ways of using this group of drugs in conjunction with hypothermia, which currently is the only accepted treatment for newborn babies with brain injury caused by oxygen deprivation at birth.

Brain damage caused by oxygen deprivation at birth, also known as hypoxic-ischemic encephalopathy (HIE), is a leading cause of death and severe disability among newborn babies. In some cases, HIE can cause cerebral palsy, although other factors, such as premature birth and other complications at birth, have been associated with the condition.