An Interview with Dr. Shyamala

Imagine devoting your livelihood to researching a deadly disorder, only to discover that years earlier that very disease took the life of your newborn cousin.

That’s exactly what happened to Dr. Shyamala Dakshinamurti, Neonatologist/Researcher at Children’s Hospital and the Children’s Hospital Research Institute of Manitoba.

“I’d been doing research for about 15 years when I went back to visit my family in India,” recalls Dr. Dakshinamurti. “I was chatting about my work when I noticed my Aunt’s face was perfectly still and her eyes were welling up. She took me to her room and pointed to a picture of a little baby, her son Sanjay, who was born around the same time I was. She told me that at 3 days of age he died from PPHN (Persistent Pulmonary Hypertension of the Newborn). I knew my Aunt had a son that died, but I never knew why. It was pure coincidence that my cousin died from the very disease I have spent the last 15 years researching. Now, every time we get closer to coming up with a new idea I look up and think ‘Sanjay, this one is for you’.”

PPHN accounts for some of the sickest babies in the NICU. About 10% of all NICU admissions are complicated by some degree of PPHN. This lethal disease occurs suddenly and often without any warning.

“The oxygen level inside the womb is the same as the top of Mt. Everest,” explains Dr. Dakshinamurti. “You don’t need much oxygen until you’re born, and up until then you don’t really need to send blood to the lungs because they’re not doing the job, Mom is doing the job. At birth babies are to take a big breath, start crying, and like magic the body goes pink as the oxygen comes in. What’s supposed to happen is that the blood vessels of the lung relax, and the blood comes in to pick up oxygen. When this doesn’t happen you have PPHN.”

In these babies the blood vessels are tightly in spasm and preventing blood from getting into the lungs, so although they can breathe, they are not taking in oxygen and they remain blue. PPHN occurs in 1-6 babies out of 1,000 births worldwide.

“We take birth for granted sometimes and assume that everything being equal, babies will come out fine,” says Dr. Dakshinamurti. “Yet, at birth a baby is essentially being taken off life support provided by Mom, and there are so many systems in place that need to begin working. If a baby doesn’t get enough oxygen either in the womb, or during delivery, PPHN can occur.”

There is no way to prevent PPHN. It is a disease of circumstance, not a disease of genetics. This can be particularly difficult for families to accept.

“PPHN only gives you a matter of days to turn it around. It’s a very severe disease and the repercussions for parents are terrible,” notes Dr. Dakshinamurti. “If the baby is born after a difficult delivery, the feelings of guilt in Mom in particular are often tremendous. We spend a lot of time reassuring the family that there was nothing they could have done to change the outcome.”

15 years ago the mortality rate for babies with PPHN was 40%. It is now between 10-25%, thanks to your donations, and the research it supports.

“Donor dollars save lives by funding research,” says Dr. Dakshinamurti. “We’re developing new insights into the tools we already have, with an eye to developing new tools so that treatments can advance. It is a truly unique environment here in Manitoba. I am very lucky to be a part of it.”

Although drug treatments for PPHN exist, there is a point when the current drugs stop working. The goal of Dr. Dakshinamurti’s research is to develop a drug to turn to when the current options fail.

“What we’re working on now is a bit of a leap of faith,” says Dr. Dakshinamurti. “We have found a central molecule that is one of the gate keepers to get blood vessels to relax. Our long run goal is to target this molecule and develop a modified drug that would activate it in the lung. It would certainly buy us time, and may be enough to save more babies with PPHN. Obviously this would make me and my team extremely happy. The only person who would be happier, would be my Aunt.”

Please give today to support lifesaving research like Dr. Dakshinamurti’s that will allow more sick babies to get better and go home.