Last week, a new Sudden Infant Death Syndrome (SIDS) study went viral after news headlines and social media posts proclaimed that scientists had discovered the root cause of the disease. And one Press release describing the research claimed that, thanks to the “breakthrough” discovery, SIDS “could soon be a thing of the past”.
However, the study in question, published on May 6 in the journal eBioMedicinehasn’t uncovered the root cause of SIDS and is unlikely to contribute to a risk assessment or a way to prevent the syndrome anytime soon, an expert told Live Science.
Rather, the research revealed a potential sign – called a biomarker – that a newborn baby might have a higher risk of dying from SIDS in the future. The study suggests there is a link between an infant’s risk of SIDS and the activity of an enzyme called butyrylcholinesterase (BChE) in their blood soon after birth. Infants who die of SIDS had relatively low BCheE activity at birth, compared to infants who died of other causes or those who survived into childhood, the study found.
“An important aspect of our finding is that it shows that many babies who succumb to SIDS are different from birth,” said the study’s lead author, Carmel Harrington, a researcher with the SIDS Research Group. SIDS and sleep apnea at Westmead Children’s Hospital, Australia. . However, “at this point, our discovery offers nothing new to clinical practice,” she told Live Science in an email.
Additionally, previous research suggests that many factors affect infants’ risk of SIDS, “so our finding is unlikely to apply to all cases of SIDS,” she added.
“Clearly there is no single cause for SIDS,” said Dr. Richard D. Goldstein, director of Robert’s Program on Sudden Unexpected Death in Pediatrics at Boston Children’s Hospital and Harvard Medical School, which did not participate in the research. The new study is an “interesting and solid contribution” to the scientific literature on SIDS, but for now, “the story of butyrylcholinesterase is very preliminary and requires much more research before understanding its real significance”, said Goldstein told Live Science in an email. .
What the study actually found
According to Centers for Disaster Control and Prevention (CDC).
Broadly, the term SUID describes any sudden, unexpected death of an infant under one year of age that has no obvious cause prior to investigation. Upon investigation, some SUIDs may be attributed to suffocation, physical trauma, or another cause, but if the child’s death “cannot be explained even after a full investigation including a full autopsy, examination of the scene of death and clinical history review,” he is classified as SIDS, according to the US Department of Health and Human Services.
Previous research largely suggests that infants who die of SIDS have insufficient autonomic functioning nervous systems — the division of the nervous system that controls involuntary bodily functions, such as breathingdigestion and heartbeat, Harrington said. SIDS has been linked to problems with wakefulness, or the process by which the body goes from sleep to wakefulness.
SIDS typically occurs during sleep and becomes more likely when caregivers put babies to sleep on their stomachs, rather than their backs or sides, according to an editorial published May 19 in the New England Journal of Medicine (NEJM). SIDS rates fell by half in the United States during the 1990s after a federal campaign raised awareness of safe sleeping positions and sleeping environments for infants. But since then, national SUID rates have hovered around the same level – around 90 infants per 100,000 live births – and a large proportion of those deaths are attributed to SIDS.
Later studies pointed to genetic factors that may increase the risk of SIDS, as well as differences in the brain and nervous system that may make it difficult for infants to wake up if they stop breathing during sleep, according to the NEJM report.
“We…decided to test the chemistry of one aspect of the autonomic nervous system, the cholinergic system that previous research has shown is known to play a role in arousal,” Harrington said.
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Nerve cells in the cholinergic system use a chemical messenger called acetylcholine (ACh) to communicate, and BCheE is one of the key enzymes that helps produce ACh. Because of this, if BCheE activity is low, it means there’s less ACh to circulate, and this deficiency can undermine the overall function of the cholinergic system, Harrington said.
In their study, the researchers measured BCheE activity in dried blood samples taken from 26 newborn babies who later died of SIDS. (Dried blood drop tests, or heel prick tests, are done soon after birth to screen babies for conditions like sickle cell disease and cystic fibrosis, according to the UK National Health Service.) The team also analyzed dried blood samples from 30 babies who later died of other unexpected causes, as well as about 550 healthy babies who survived infancy.
On average, infants who died of SIDS showed lower BCheE activity than healthy infants and those who died of other causes. This suggests that measuring BCheE at birth could help flag infants at risk for SIDS and one day find ways to prevent the syndrome, the authors wrote in their report.
However, “there is a lot of work to be done before we understand how specifically it can identify risk,” Goldstein told Live Science.
Based on the results of the new study, it would not be possible to develop a foolproof screening test for SIDS based solely on BCheE. Although the SIDS group showed lower BCheE activity than the other groups, overall, at the individual level, their measurements overlapped with those of infants in the healthy group. So, in isolation, measuring BCheE would not be a strong indicator of a newborn’s future risk of SIDS, The Atlantic reported.
Another limitation of the study is that the team analyzed BCheE activity near the time of birth but not at the time of death, so it is unclear whether levels remained as low at the time of death. babies, Harrington said. Additionally, the study relied on coroner’s diagnoses rather than autopsy reports to confirm the cause of death, so the true cause of death may have been uncertain in some cases.
In short, there is still work to be done before fully understanding the role of BCheE in SIDS.
Originally posted on Live Science.
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