Saving the brain

In 2010, the American Academy of Pediatrics advised against postnatal use of high-dose dexamethasone, a powerful glucocorticoid used to boost circulation and lung function in preterm infants, because of the risk of stunted brain development.¹ Now, researchers at the University of California, San Francisco have found that although the fallback glucocorticoid hydrocortisone poses a similar risk,² there may be a way to blunt the negative effects of glucocorticoids on the brain by using smoothened.³ Safety concerns of such an approach will have to be addressed next.

Premature delivery is associated with cerebral palsy and developmental delay caused by hypoxia or intraventricular hemorrhage. Glucocorticoids are used to counter hypotension and breathing problems in about 20% of cases of premature delivery, said Emily Tam, assistant professor of neurology and pediatrics at UCSF. "These are major problems for which there aren't other good options."...