With a clinical trial on the cards and training programs under way, a measure that’s as simple to apply as a bandaid is showing great potential to save millions of babies’ lives in low-resource countries.
A multidisciplinary team from the Ritchie Centre (at Monash Institute of Medical Research-Prince Henry’s Institute and Monash University) made news earlier this year by showing that a melatonin patch could neutralise the effects of birth asphyxia, a lack of oxygen caused by complications such as umbilical cord entanglement or obstructed delivery.
The ability of melatonin to reduce brain damage was first confirmed almost a decade ago by team co-leader Dr Suzie Miller. Working with Ritchie Centre deputy director Professor Graham Jenkin and director Professor Euan Wallace, Dr Miller showed for the first time that melatonin, a naturally occurring hormone and powerful antioxidant, could efficiently mop up the dangerous oxygen free radicals that flood the system and cause brain injury after asphyxia.
Dr Miller and her colleagues more recently showed, with pre-clinical research by PhD candidate James Aridas, that a simple patch – similar to those used to offset jetlag – is effective in reducing brain damage following birth asphyxia.
It is particularly significant because it means that melatonin could be administered cheaply and simply in community settings as well as in hospitals, making it ideal for use in developing countries such as India.
Every year, almost four million babies die before they are a month old. Some 1.5 million of these deaths occur in India alone – and more than half are due to asphyxia at birth.
“The exciting thing is that it doesn’t require intensive care,” Dr Miller says. “The melatonin patch doesn’t even need refrigeration. It is literally applied like a bandaid.”
Other team members, Associate Professor Michael Fahey, head of paediatric neurology at Monash Children’s Hospital in Melbourne, and Dr Atul Malhotra, a neonatal paediatrician at Monash Children’s Hospital, are now involved in on-the-ground work in Lucknow, in India.
The team hopes to start a pilot study soon with Indian partner hospital King George’s Medical Centre in Lucknow, and is establishing training clinics in nearby rural areas, where health workers are being taught to recognise birth asphyxia so that melatonin patches can also be used out in the community.
“We’ve got an opportunity to bring into this setting something that is cheap, easily translatable, stable, safe and doesn’t require high technology to make a massive impact both in India and around the world,” Associate Professor Fahey says.
Read the full story of work by Professor Euan Wallace, Professor Graham Jenkin, Associate Professor Michael Fahey, Dr Suzie Miller and Dr Atul Malhotra in A patch of life in the October issue of Monash magazine.