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Nearly half a million newborns are born prematurely in the United States each year. Toddlers whose lungs are too fragile to maintain normal breathing spend the first hours of their lives in sterile plastic boxes hanging from tubes and monitors until the medical team considers them strong enough to be wrapped around their mothers’ breasts.

But steroids, which help reduce inflammation and support the development of the lungs and nerves, often come at a price that pediatricians and families are not willing to pay. Newborns are at risk for neurological complications, including cerebral palsy, susceptibility to depression, reduced brain size, and severance of connections between nerve cells.

Fortunately, the solution may already be on the way. In an article published in this magazine Disease neurobiology, A team of researchers at the University of Pittsburgh Medical School has found that an inhaled drug approved for the treatment of asthma in young children can have a beneficial effect on the lungs of newborn rats without causing side effects to the brain.

“We are very excited about our discoveries, we hope it will not take long to turn them into clinical applications,” said Dr. Donald Defranco, senior author and professor at Pete’s Department of Pharmacology and Chemical Biology. “An effective drug that treats neonatal lung injury without worrying about the serious side effects of neurodevelopment will make a big difference to the doctors who care for those patients.”

In a pre-clinical study in Pitt, researchers found that cyclesonide, an asthma drug that activates the same receptors as the regular steroid dexamethasone, lowers the markers of pneumonia, stimulates blood vessel repair, but, unlike dexamethasone, does not promote structure. or molecular. changes in the brain

According to DeFranco, the key is for the body to process cycliconide. Instead of acting on all scattered molecular targets, it is activated only in limited tissues of the body, such as the lower airways of the lungs.

“It is very interesting to be involved in a study that has the potential to lead to the treatment of premature infants,” said Julian Umum Aumot, a researcher at the Pittsburgh Neurodegenerative Diseases Institute. “When I started treating newborn rats with dexamethasone cycloneid, I was amazed at how different the effects were. “Animals treated with dexamethasone will be fragile and underweight when cycloneid-treated rats behave normally.”

Encouraged by promising results, the team is working with colleagues at the Kansas City Children’s Mercy Hospital to see if cyclesonide can help newborns at NICU.

The urgency to improve the clinical management of lung disease was exacerbated during the era of the COVID-19 epidemic. Researchers say that developing safer alternatives to steroid medications for patients with severe COVID-19 may be especially helpful for pregnant women who are concerned about the long-term effects on their newborns.

“Premature babies are such a vulnerable population. “We’ve flown borders to help them survive, but we can still do better,” said Dr. Alexis Franks, Pitt’s pediatric assistant. “The opportunity to develop new therapies that play an equalizing role in helping children achieve their neurodevelopmental goals, whether they are born early or not, will level the playing field and give children a greater chance of achieving their full potential.”

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