In a world-first medical breakthrough, Monash Children’s Hospital, in collaboration with Hudson Institute of Medical Research and Monash University, is leading a clinical trial that could revolutionise the treatment of prenatal strokes.
Senior Neonatologist and Head of the Early Neurodevelopment Clinic at Monash Children’s Hospital, Associate Professor Atul Malhotra, leads this effort. It promises to offer new hope to parents and their unborn babies facing the devastating effects of prenatal strokes.
“Every year in Australia, about 600 babies suffer a stroke in utero, and the effects can be devastating, including cerebral palsy and a range of other neurodevelopmental conditions,” A/Prof Malhotra explained. But thanks to a cutting-edge trial using stem cells from a baby’s own umbilical cord blood, these grim statistics could soon be a thing of the past.
“It’s often possible to diagnose a stroke, generally a rare event, during regular ultrasound scans in pregnancy, but until now, there’s been very little we could do to combat the effects on the child,” A/Prof Malhotra said.
The trial, coined the STELLAR trial, is the first of its kind. It aims to halt the effects of prenatal strokes using the regenerative power of umbilical cord blood stem cells. A/Prof Malhotra describes the trial as a potential game-changer, providing a new avenue for treatment where previously there was none.
“These stem cells have neuroprotective, neuroregenerative, immunomodulatory, and anti-inflammatory properties, and we hope to prove that they can reverse some of the brain damage caused by pre-birth strokes,” A/Prof Malhotra said.
In other words, these stem cells help in a number of crucial ways:
The neuroprotective properties mean they can shield nerve cells from further damage, preserving the brain’s structure and function after a stroke.
The neuroregenerative properties allow them to repair and regenerate nerve cells and tissues, potentially restoring lost functions by encouraging the growth of new neurons and repairing damaged areas.
The immunomodulatory properties help in modulating the immune response to promote healing and reduce harmful inflammation in the brain.
The anti-inflammatory properties reduce inflammation in the brain, which is important because inflammation can worsen damage and hinder the healing process. By reducing inflammation, the stem cells create a better environment for recovery and repair.
Under the trial, stem cells are harvested from a baby’s umbilical cord blood, collected at birth and processed by industry partner Cell Care. These cells are then transported to the Hudson Institute for final product preparation and reintroduced into the infant’s bloodstream during the first few weeks of life.
A/Prof Malhotra highlighted the trial’s unique aspects, stating, “One of the most remarkable aspects of this trial is that we are using the baby’s own cord blood. This approach minimises the risk of reactions, rejection and other complications, making it a safer option for these vulnerable patients.”
He added, “Our goal is to intervene as early as possible, ideally within the first few days of life, to maximise the potential for brain repair and recovery.”
The first baby in the trial has already undergone this groundbreaking treatment, and the results are promising.
Lauren Whalley, the mother of the trial’s first participant, Chase (pictured above), expressed her hope and gratitude. “We knew it couldn’t hurt Chase; it could only help him. Research is the only way to move forward toward better treatments,” she said.
A/Prof Malhotra reflected on the trial’s impact, saying, “Seeing the potential benefits firsthand and hearing from families like Chase’s reminds us why we embarked on this journey. It’s incredibly rewarding to witness even small improvements in the lives of these children and their families.”
The trial is still in its early stages, focusing on proving the treatment’s feasibility and safety, and the team is reaching out to hospitals across Victoria looking after pregnant women with babies diagnosed with prenatal stroke. If successful, the next phase will involve a larger trial to evaluate long-term benefits.
“The ultimate goal is for these children to have the best possible chance of developing to their full potential,” said A/Prof Malhotra.
A/Prof Malhotra and his team’s groundbreaking work represents a significant leap forward in neonatal care. By harnessing the power of umbilical cord blood stem cells, they are paving the way for a future where the devastating effects of prenatal strokes can be mitigated if not entirely prevented.
Approved by Angus Henderson, General Manager, Research Strategy