The Institute for Cellular and Molecular Medicine (ICMM) in the Faculty of Health Sciences at the University of Pretoria is making waves in maternal, child and women’s health. Through its collaboration with the South African Medical Research Council (SAMRC) and the Bill and Melinda Gates Foundation (BMGF), the ICMM is involved in a ground-breaking research initiative to understand the pathogenesis of birth asphyxia, also known as hypoxic ischemic encephalopathy (HIE).

HIE is a critical concern worldwide. It arises from reduced oxygen supply to the infant's brain during birth and can lead to severe consequences, including cognitive impairments and cerebral palsy. This is the most highly litigated area in medical negligence claims in South Africa.

HIE affects lower-to-middle-income countries disproportionately, occurring ten times more frequently than in high-income countries. The standard treatment, therapeutic hypothermia, is often inaccessible in LMICs. This necessitates innovative approaches to treating affected neonates.

The NESHIE research group, led by Prof. Michael S Pepper, is on a relentless pursuit to understand the molecular underpinnings of HIE. Their goal? To identify biomarkers for personalised treatments, with funding from SAMRC and the BMGF.

The NESHIE study is comprehensive, analysing data from over 450 neonates with moderate and severe HIE. Clinical parameters, genetics, gene expression profiles, proteins, metabolites, placental health including microbiome, and portable MRI machines have all been included in the study to ensure comprehensive coverage of potential contributory factors.

Excitingly, the study has unearthed significant genetic variants and critical molecules associated with HIE severity. These findings have the potential to revolutionise prevention and treatment decisions, especially in LMICs.

Prof Michael Pepper presenting at NeuroCon 2023

The NESHIE research group recently shared their ground-breaking discoveries at the NeuroCon 2023 conference in London. Prof. Pepper remarked, “The NESHIE study is ongoing, and we are entering the fifth and final consecutive year of sample and data collection. We understand that this is the largest cohort of its kind globally, and through our unique multi-omics approach, we are beginning to produce highly original data that has the potential to make a significant impact on the prevention and treatment of NESHIE.”

The NESHIE study has entered its fifth year of data and sample collection, making this the largest cohort of its kind worldwide. Their unique multi-omics approach promises to leave an indelible mark on HIE prevention and treatment.

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