Stories about: Innovation

Inhaled hydrogen could protect the brain during heart-lung bypass

hydrogen gas
ILLUSTRATION: ELENA HARTLEY / BOSTON CHILDREN’S HOSPITAL

Newborns with life-threatening congenital heart disease often undergo open-heart surgery with cardiopulmonary bypass, which carries a risk of damaging the brain. Critically ill newborns who are placed on ECMO are at even higher risk for brain injury.  Hypothermia, or cooling the body, can improve neurologic outcomes, but has limitations.

A new study in a large animal model suggests that adding a dash of hydrogen to the usual mix of respiratory gases could further protect babies’ brains.

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A first in medical robotics: Autonomous navigation inside the body

illustration of an autonomous medical robot advancing to the site of a leaky heart valve
A self-driving robotic catheter, inserted at the base of the heart, arrives at a leaky valve. ILLUSTRATION: RANDAL MCKENZIE

Surgeons have used robots operated by joysticks for more than a decade, and teams have shown that tiny robots can be steered through the body by external forces such as magnetism. Now, a paper in Science Robotics describes a robotic catheter that can navigate autonomously — the surgical equivalent of a self-driving car.

Bioengineers at Boston Children’s Hospital demonstrated a robotic catheter that found its way along the walls of a beating, blood-filled heart to a leaky valve in an animal model, without a surgeon’s involvement.

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Small samples, big data: A systems-biology look at a newborn’s first week of life

newborn biology, through tiny blood samples
(PHOTO: ADOBE STOCK)

The first week of a baby’s life is a time of rapid biological change. The newborn must adapt to living outside the womb, suddenly exposed to new bacteria and viruses. Yet scientists know surprisingly little about these early changes.

Reporting in today’s Nature Communications, an international research team provides the most detailed accounting to date of the molecular changes that occur during a newborn’s first seven days. The team pioneered a technique to extract volumes of data from a tiny amount of newborn blood — including what genes are turned on, what proteins the body is making and what metabolites are changing.

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Eavesdropping on mitochondria, tissue by tissue

mitochondria
(IMAGE: ADOBE STOCK)

First in a two-part series on mitochondria. See part 2.

Mitochondria are essential to life: they produce energy, synthesize building blocks critical to cell function and help regulate cellular activity, including programmed cell death. Mitochondrial diseases can cause severe metabolic disorders in children and dysfunctional mitochondria are thought to play a role in cancer, diabetes, heart attack, stroke, Parkinson’s disease and more.

A new research tool offers an unprecedented glimpse at the workings of these tiny, dynamic organelles, and could aid in the study of mitochondrial dysfunction.

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Light-activated nanoparticles could avoid painful eye injections for ‘wet’ macular degeneration

Could intravitreal injections become a thing of the past?
(PHOTO: ZKALILA1998 / WIKIMEDIA COMMONS)

There are two standard treatments for “wet” age-related macular degeneration (AMD), in which abnormal, leaky blood vessels in the back of the eye lead to fluid buildup and vision loss. The first, injection of medication directly into the eye, can be painful and can cause inflammation, infection and detachment of the retina. The second, ablation therapy, uses lasers to destroy the leaky blood vessels. It, too, is unpleasant to undergo, and the lasers can also destroy surrounding healthy tissue, causing further vision loss.

In today’s Nature Communications, the lab of Daniel Kohane, MD, PhD, provides proof-of-concept of a more tolerable alternative: tiny, drug-carrying nanoparticles that can be injected intravenously, but deliver medication only to the eye.

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Two new options for treating esophageal damage in children

Rusty Jennings, MD, and Michael Manfredi, MD (CREDIT: MICHAEL GODERRE)

A child’s esophagus can become damaged through physical trauma or ingestion of toxic chemicals or foreign objects — such as oven and drain cleaners, lye, laundry and dishwasher detergents and batteries. Depending on the substance and the amount ingested, children can develop esophageal strictures (scar tissue that narrows the esophagus) or esophageal perforations (holes in the esophagus). These problems can also be complications of surgery for esophageal atresia, in which a baby is born without part of the esophagus.

Children with esophageal perforations have traditionally been treated with long courses of antibiotics and not eating by mouth. More recently, perforations have been treated with stents, and strictures with a combination of dilation and stenting. But stenting, while it can be effective, requires up to eight weeks of therapy and can have complications such as pain, retching and local pressure necrosis, a type of ulcer that may worsen perforation. Such concerns have led researchers to investigate alternative treatments for perforation and strictures.

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Can we mass-produce platelets in the lab?

Lab-grown platelets could someday be given to patients
Activated platelets (IMAGE: ADOBE STOCK)

Most of us have somewhere around a trillion tiny platelets zooming around our bloodstreams. Joseph Italiano, PhD, of Boston Children’s Hospital’s Vascular Biology Program, calls them the “Swiss Army knives of the blood.” In addition to their key role in clotting, platelets are important in immunity, wound healing, chemical delivery, blood vessel development and more.

At healthcare facilities, platelets are in constant demand for patients with blood diseases, or those receiving radiation or chemotherapy for cancer. But unlike other blood products, platelets can’t be stored for more than a few days. If there’s a snowstorm or other emergency preventing donors from giving platelets, a hospital can easily run out. So researchers have been trying to make platelets in a lab setting.

Two teams at Boston Children’s Hospital are tackling the problem in slightly different ways.

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Gene panel helps investigate sudden unexpected death in children

Thousands of cases of sudden unexplaied death (SUDP) occur each year.
(PHOTO: ADOBESTOCK)

Almost 10 percent of pediatric deaths occur suddenly and without explanation. In this terrible situation, the first question many parents have is “Why?” For most, answers never come.

Childhood deaths that cannot be explained by traditional autopsy and death-scene investigation are referred to as sudden unexplained deaths in pediatrics (SUDP). In children, these deaths are more common than those from either cardiac disease or cancer and typically occur in infancy or early childhood.

Robert’s Program at Boston Children’s Hospital, co-founded by Richard Goldstein, MD, and Hannah Kinney, MD, is adding a genetic approach to the search for answers.

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New technique images whole brains with incredible resolution

Overview of brain structures captured by new imaging technique
Combined expansion microscopy and lattice light-sheet microscopy allows for highly detailed images to be taken over large sections of the brain. (IMAGES COURTESY SRIGOKUL UPADHYAYULA, RUIXUAN GAO, AND SHOH ASANO)

Decades ago, discoveries about the brain’s intricate anatomy were made with careful dissection and drawings. Today, they’re made with super-resolution imaging and massive computing power capable of handling hundreds of terabytes of data.

In this week’s Science, a team out of the Massachusetts Institute of Technology (MIT), the Janelia Research Campus of the Howard Hughes Medical Institute (HHMI), Harvard Medical School (HMS) and Boston Children’s Hospital, describes a technique capable of imaging whole brains at exquisitely high resolution, allowing scientists to distinguish tiny sub-cellular structures.

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Using multiple data streams and artificial intelligence to ‘nowcast’ local flu outbreaks

(PHOTO: ADOBESTOCK)

Because influenza is so contagious, it’s been challenging to track and forecast flu activity in real time as people move about and travel. While the CDC continuously monitors patient visits for flu-like illness in the U.S., its information can lag by up to two weeks. A new study led by the Computational Health Informatics Program (CHIP) at Boston Children’s Hospital combined multiple approaches, providing what appear to be the most accurate local flu predictions to date.

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