Rescuing the neonatal brain from hypoxic injury with autologous cord blood.
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.
Type
Journal articleSubject
AnimalsHumans
Hypoxia, Brain
Birth Injuries
Cord Blood Stem Cell Transplantation
Infant, Newborn
Multicenter Studies as Topic
Randomized Controlled Trials as Topic
Autografts
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https://hdl.handle.net/10161/24686Published Version (Please cite this version)
10.1038/bmt.2012.169Publication Info
Liao, Y; Cotten, M; Tan, S; Kurtzberg, J; & Cairo, MS (2013). Rescuing the neonatal brain from hypoxic injury with autologous cord blood. Bone marrow transplantation, 48(7). pp. 890-900. 10.1038/bmt.2012.169. Retrieved from https://hdl.handle.net/10161/24686.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Joanne Kurtzberg
Jerome S. Harris Distinguished Professor of Pediatrics
Dr. Kurtzberg is an internationally renowned expert in pediatric hematology/oncology,
pediatric blood and marrow transplantation, umbilical cord blood banking and transplantation,
and novel applications of cord blood and birthing tissues in the emerging fields of
cellular therapies and regenerative medicine. Dr. Kurtzberg serves as the Director
of the Marcus Center for Cellular Cures (MC3), Director of the Pediatric Transplant
and Cellular Therapy Program, Director of the Carolina

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