Andrea Jonsdotter: Improving the outcome in infants with brain injury
Premature infants are at increased risk of brain damage. Currently, there is no established standard treatment for these children. Andrea Jonsdotter’s doctoral thesis explores several strategies with the potential to reduce brain damage in newborns once they occurred.
ANDREA JONSDOTTER
Dissertation defense: 26 April 2024 (click for details)
Doctoral thesis: Perinatal brain damage-phagoptosis and neuroprotection
Research area: Obstetrics and Gynecology
Sahlgrenska Academy, The Institute of Clinical Sciences
What is the background to your thesis?
“Brain damage in premature infants currently lacks a standard treatment. While full-term infants with brain damage due to oxygen deprivation can benefit from cooling therapy, it doesn’t help everyone. My thesis aims to understand the immature brain and its mechanisms better to facilitate the discovery of treatments for brain-damaged infants,” says Andrea Jonsdotter, a researcher at the Institute of Clinical Sciences and a specialist in obstetrics and gynecology at Sahlgrenska University Hospital.
What does your research focus on?
“It involves studying exendin-4, currently used as a diabetes medication. Studies on adults have shown its neuroprotective effects and improved functional outcome. Therefore, we aimed to explore its potential neuroprotective effects on the immature brain after brain damage.”
Single-dose magnesium sulfate
Andrea Jonsdotter further explains:
“Magnesium sulfate is a well-known medication, and we already know that it is administered in many countries where women are at risk of preterm birth to protect the baby's brain in the womb. Therefore, we have investigated whether a single dose of 6 grams of magnesium sulfate infusion given to women with imminent risk of preterm birth, before the 32nd week of pregnancy is tolerated, both by the mother and the newborn, along with blood samples after infusion to the woman, measuring magnesium levels in woman and from the umbilical cord. Additionally, we have studied the MerTK receptor, a phagocytic receptor, activated during brain damage. We have looked into the effect of knocking out the MerTK gene to see if it offers any protective effect on the immature brain after oxygen deprivation-induced brain damage and reduced blood flow.”
“Significant neuroprotective effect”
What are the most important research findings?
“We found that magnesium sulfate was well-tolerated by the mother, with no serious side effects noted, and achieved the desired concentration in both the mother and the baby. This is now being followed up in a national ongoing study following the introduction of a six-gram magnesium sulfate treatment for women with risk of delivery before 32 weeks of gestation throughout Sweden,” says Andrea Jonsdotter, adding:
“We have demonstrated that Exendin-4 has significant neuroprotective effects in rats and mice following both hemorrhagic brain injury and hypoxic-ischemic brain injury.”
What are your thoughts on this?
“That’s amazing, as cooling therapy doesn’t work for all full-term infants born with brain damage, and especially because there is currently no treatment available for premature infants born with brain damage. Studies with exendin-4 are currently underway in larger animals, and hopefully, we’ll see it clinically used as a treatment for neonatal brain injury in the future.”
Text: Jakob Lundberg