A combination of light therapy and albumin therapy may be a promising way of preventing brain damage in cases of severe jaundice in newborn babies and adults. This is the conclusion drawn by UMCG researcher Andrea Schreuder in her thesis. Schreuder will receive her PhD-degree at the University of Groningen on 12 February.
Seventy percent of term babies, and all premature babies, become slightly jaundiced after birth. This condition is caused by high levels of bilirubin, a yellow colouring agent in our blood plasma. Bilirubin is a breakdown product of red blood cells . Bilirubin is normally secreted via the liver, bile and faeces. This process is not fully effective in newborn babies. Babies with high levels of bilirubin are usually treated with light therapy (so called phototherapy), which is an effective treatment option.
The condition is not always noticed in time and some babies may require a blood transfusion. There is also a small group of patients with a disorder known as Crigler-Najjar disease. They have a genetic defect, whereby their liver enzyme does not work, making them unable to metabolize bilirubin. Seriously high levels of bilirubin in the blood (hyperbilirubinemia) can lead to brain damage, a complication suffered by 25% of Crigler-Najjar patients, despite daily light therapy. This therapy can take up to 16 hours a day for this group of patients. The shorter duration of treatment for newborn babies might make it less intensive, but newborns can also suffer from brain damage if the light therapy is not effective. It is therefore enormously important to develop new treatment strategies.
In her research, Schreuder discovered that a combination of light therapy and administering extra albumin could be an effective treatment option. Albumin is a protein in blood plasma, which binds easily with bilirubin. Schreuder’s study shows that this not only leads to a significant drop in bilirubin levels in the blood, but that it also prevents bilirubin from accumulating in the brain. These findings can be used to develop clinical studies for Crigler-Najjar patients and newborn babies with severe jaundice.
Andrea Schreuder (Hardenberg, 1985) studied Medicine at the University of Groningen. She conducted her PhD research at the Beatrix Children’s Hospital of the University Medical Center Groningen. Her research was funded by the Groningen University Institute for Drug Exploration (GUIDE). Schreuder now works as a paediatric resident in the Medical Center of Leeuwarden. Her thesis is entitled: ‘Diagnosis and treatment of unconjugated hyperbilirubinemia: experimental and clinical aspects’.
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