Elucidation of the mechanism of thrombocytopenia in SGA infants and therapeutic strategy for improving neurodevelopment by controlling platelets

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K16939
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52050:Embryonic medicine and pediatrics-related
• Research Institution: Aichi Medical University
• Principal Investigator: Takeshita Satoru 愛知医科大学, 医学部, 助教 (20715875)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 新生児学 / 胎児発育遅滞 / SGA児 / 血小板減少 / トロンボポエチン / 神経保護

Outline of Final Research Achievements

Fetal growth is retarded due to chronic hypoxic conditions in the uterus, such as gestational hypertension, and small for gestational age (SGA) infants are born. The number of SGA infants is increasing in Japan, and prevention and treatment of complications are becoming increasingly important. We have shown that thrombocytopenia in human SGA infants is due to the suppression of platelet production associated with a decrease in serum thrombopoietin (TPO) levels. Using a rat model of SGA, they also showed that the cause of TPO reduction is decreased TPO expression due to immature liver, and that administration of a TPO receptor agonist can improve thrombocytopenia. These results are reported in the paper. Currently, further studies are underway to improve the neuro-prognosis of SGA infants.

Free Research Field

新生児学

Academic Significance and Societal Importance of the Research Achievements

現在日本で臨床使用されているTPO受容体作動薬はエルトロンボパグとロミプロスチムのみで、適応は主に成人の慢性血小板減少性紫斑病である。新生児血小板減少症の原因が分子生物学的レベルで解明され、TPOの動向が明らかになれば、TPO受容体作動薬が新生児血小板減少症の新規治療薬となる可能性がある。血小板輸血の代替治療は、輸血に伴う感染症などのリスクを回避するだけでなく、貴重な医療資源の負担を軽減することができる。さらに、SGA児の合併症の予防と治療は、SGA児本人だけでなく家族や社会全体にも利点が大きく、新たな治療は我が国の将来を担う子どもと子どもを支える社会の両方に恩恵を与えると期待できる。