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Experiments in sheep are hinting that doses of caffeine given to women in pregnancy, as well as their newborns after birth, could prevent cerebral palsy.
Cerebral palsy is a disabling condition often caused by asphyxia -- reductions in oxygen supply -- around the time of birth. Asphyxia can cause other neurodevelopmental disorders, as well.
Researcher Dr. Emin Maltepe, a neonatologist at the University of California, San Francisco's Benioff Children’s Hospital, explained how caffeine might prevent asphyxia damage.
“Caffeine has previously proven to be safe in stimulating the respiratory centers of preterm babies and helping them remember to breathe,” said Maltepe, who is senior author of the new study.
Caffeine “easily crosses the blood-brain barrier and is a potent antioxidant and anti-inflammatory molecule,” added first study author Dr. Jana Mike, a pediatric intensivist at the same hospital.
Maltepe and Mike published their findings Oct. 21 in the journal Stroke.
In the new study, 30 pregnant sheep received either a single intravenous dose of one gram of caffeine, which is equal to about 10 cups of coffee, or a placebo IV shot.
Then, after their lambs were born and asphyxia was induced, some lambs got a large dose of caffeine followed by lesser doses each day for two days. The other lambs received the placebo.
Measures of systemic inflammation, called cytokines, were significantly less among lambs exposed to caffeine, compared to those who weren't, the San Francisco team reported. The treated lambs also had less signs of injury to gray and white matter in their brains.
Treated lambs also appeared more active -- eating and moving around more -- compared to the untreated animals.
The caffeine dose appeared to have no deleterious effect on the lamb moms, the researchers added.
“We’re excited about the potential this brings for preventing long-term disability in babies with birth asphyxia, particularly in less resourced countries where the current treatment is less effective and the need for prenatal treatment is greatest,” Maltepe said in a UCSF news release.
The researchers note that 95% of cerebral palsy cases worldwide currently arise in poorer nations.
Right now, the only therapy given to newborn known to have undergone a period of low oxygen is to temporarily cool their bodies for 72 hours, then slowly rewarm it. But even in wealthier nations with high-quality hospitals the treatment is only "modestly effective" in easing the worst effects of cerebral palsy, the researchers said.
According to a university news release, "this could be because brain hypoxia occurs earlier in gestation, possibly due to the inability of the placenta to provide enough nourishment to the developing fetus."
The research was funded by the Bill annd Melinda Gates Foundation. Researchers like Maltepe and Mike were charged with seeking out medicines that might prevent or lessen damage from asphyxia.
“We reviewed over 1,000 drugs, taking an unbiased, agnostic look at potential therapies for this patient population,” Maltepe explained. “I didn’t expect caffeine to be the frontrunner, but it was the most effective of all the ones we examined, and significantly more effective than the current standard of care."
Of course, research conducted in animals often fails to pan out in people. However, the San Francisco team are optimistic and note that clinical trials in women and newborns are already being planned at sites around the world.
“We’re excited about the potential this brings for preventing long-term disability in babies with birth asphyxia, particularly in less resourced countries where the current treatment is less effective and the need for prenatal treatment is greatest,” Maltepe said.
More information
Find out more about cerebral palsy at the National Institute of Neurological Disorders and Stroke.
SUORCE: University of California, San Francisco, news release, Oct. 21, 2024