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Rescuing the neonatal brain from hypoxic injury with autologous cord blood

Bone Marrow Transplantation volume 48, pages 890–900 (2013)Cite this article

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Abstract

Brain injury resulting from perinatal hypoxic-ischemic encephalopathy (HIE) is a major cause of acute mortality in infants and chronic neurologic disability in surviving children. Recent multicenter clinical trials demonstrated the effectiveness of hypothermia initiated within the first 6 postnatal hours to reduce the risk of death or major neurological disabilities among neonates with HIE. However, in these trials, approximately 40% of cooled infants died or survived with significant impairments. Therefore, adjunct therapies are required to improve the outcome in neonates with HIE. Cord blood (CB) is a rich source of stem cells. Administration of human CB cells in animal models of HIE has generally resulted in improved outcomes and multiple mechanisms have been suggested including anti-inflammation, release of neurotrophic factors and stimulation of endogenous neurogenesis. Investigators at Duke are conducting studies of autologous CB infusion in neonates with HIE and in children with cerebral palsy. These pilot studies indicate no added risk from the regimens used, but results of ongoing placebo-controlled trials are needed to assess efficacy. Meanwhile, further investigations are warranted to determine the best strategies, that is, timing, dosing, route of delivery, choice of stem cells and ex vivo modulations, to attain long-term benefits of CB stem cell therapy.

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Acknowledgements

We thank Erin Morris, RN, for her excellent assistance in the preparation of the manuscript. This work was supported in part by the Pediatric Cancer Research Foundation.

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Authors and Affiliations

  1. Department of Pediatrics, New York Medical College, Valhalla, NY, USA

    Y Liao & M S Cairo

  2. Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA

    M Cotten & J Kurtzberg

  3. Department of Pediatrics, Evanston Northwestern Healthcare and Northwestern University, Evanston, IL, USA

    S Tan

  4. Department of Medicine, New York Medical College, Valhalla, NY, USA

    M S Cairo

  5. Department of Pathology, New York Medical College, Valhalla, NY, USA

    M S Cairo

  6. Department of Immunology and Microbiology, New York Medical College, Valhalla, NY, USA

    M S Cairo

  7. Department of Cell Biology and Anatomy, New York Medical College, Valhalla, NY, USA

    M S Cairo

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  1. Y Liao
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  2. M Cotten
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  3. S Tan
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  4. J Kurtzberg
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  5. M S Cairo
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Correspondence to M S Cairo.

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Liao, Y., Cotten, M., Tan, S. et al. Rescuing the neonatal brain from hypoxic injury with autologous cord blood. Bone Marrow Transplant 48, 890–900 (2013). https://doi.org/10.1038/bmt.2012.169

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  • DOI: https://doi.org/10.1038/bmt.2012.169

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