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Summer Edition - December 2020
Summer Edition - December 2020
In this edition:
- Parents infected with COVID-19, but children protected. How?
- Mini-kidneys could be the answer to treat kidney failure
- What's the link between parent mental health and premature birth?
- The one reason why most babies see a GP
- Celebrating 2020: Creating possible, together
- Understanding children’s needs in the middle years
- COVID-19 increasing the risk of a measles infection boom
Parents infected with COVID-19, but children protected. How?
Both parents in a Melbourne family were infected with COVID-19, but their three children were not. Why didn’t the children get the virus?
When a Melbourne couple went to Sydney for a wedding early in 2020, they expected to return home to their primary school-age children with happy memories, not the virus that causes COVID-19. But then they developed symptoms: coughs, congestion, fever and headache.
Tests confirmed that the parents had COVID-19.
Yet, despite close family contact with their children, including sharing a bed with the youngest, all three children mounted a successful immune response to the infection and all showed only mild symptoms or none at all.
The children’s COVID-19 tests remained negative.
MCRI’s Dr Melanie Neeland and her team performed a careful analysis of the immune cells and antibody types, which showed that the children mounted an immune response that potentially stopped the virus in its tracks.
“The youngest child, who showed no symptoms at all, had the strongest antibody response,” says Melanie.
“Despite the active immune response in all children, levels of cytokines remained low. This was consistent with their mild or no symptoms.”
Cytokines are molecular messengers in the blood that can trigger the reaction that makes COVID-19 so dangerous.
The family’s case told researchers an important story about the differences in the way adult and child immune systems respond to this new virus.
MCRI Associate Professor Nigel Crawford said the study raised the possibility that despite chronic exposure, children’s immune systems allowed them to effectively stop the virus from replicating inside their cells.
“Investigating immune responses to SARS-CoV-2 across all age groups is key to understanding disease susceptibility, severity differences, and vaccine candidates.”
Mini-kidneys could be the answer to treat kidney failure
Right now, we don’t know how toxic a new drug might be until we can try it out on a human patient. These bio-printed mini-kidneys could be the answer.
One in 10 people worldwide has chronic kidney disease, including many children. Chronic kidney disease (CKD) means that the kidneys cannot do their important work of cleaning waste out of the blood, leading to a build up of toxins.
A major roadblock to being able to develop new and effective drugs for CKD is high costs and high chance of failure between the lab and the patient.
MCRI’s Professor Melissa Little is a world leader in modelling the human kidney, and says “drug development is a very expensive business, but it’s most expensive because most products don’t reach the market. They get to clinical trial, and they’re found to be either not effective or not safe.”
“The toxicity of a new drug to the kidney is one of the main problems, and we don’t find that out until we reach humans because we don’t have good models. Being able to screen whether a new drug is toxic to the kidney, using a model in the form of a human kidney grown in a dish, will be a big advantage.”
With the 3D bio-printed mini-kidneys that she and her team have developed, new drugs can be tested in the lab to find their safety and efficacy before they go anywhere near a human. It’s cheaper, faster and safer.
One day, these mini kidneys could even be the basis for transplantable organs. Before this study, says Melissa, the possibility of using mini kidneys to generate transplantable tissue was too far away to contemplate.
But this new bio-printing method is faster, more reliable and allows the whole process to reach more people, more quickly. 3D bioprinting could now create about 200 mini kidneys in 10 minutes without compromising quality. The result is mini-kidneys that fully resemble a regular-sized kidney, including the tiny tubes and blood vessels that form the organ’s filtering structures.
Watch Melissa talk about the impact of ‘mini-organ’ models for health research.
What's the link between parent mental health and premature birth?
Mental health problems are on the rise. Now, research has shown the impact of mental health on premature births, and both parents play a part.
For the first time, research has shown that men with persistent mental health problems through adolescence and young adulthood were more likely to have a baby who was born premature.
For women, the mental health problems of anxiety and depression during pregnancy were connected to increased rates of preterm birth, which account for just under one in 10 births in Australia. Preterm birth is associated with increased risk of behavioural problems and learning difficulties in childhood.
“We found that men with persistent mental health symptoms in the decades leading up to pregnancy were more likely to father premature babies,” says Dr Elizabeth Spry from MCRI and Deakin University, who co-led the study.
Before this study, the impact of maternal and paternal mental health history on babies’ preterm birth and birth weight was unknown.
“Most research on children’s early development has focused on mums,” says Elizabeth. “This means that public health recommendations are also almost entirely focused on what mums should and shouldn’t do when planning pregnancy or having a child. In contrast, men receive very little guidance or support.”
The other clear lesson from this finding is that caring for adolescent boy’s mental health is important for the health of the babies they may go on to have in the future.
MCRI’s Professor George Patton emphasises that need, particularly given the challenges of 2020.
“Rates of anxiety and depression have risen markedly in adolescents and young adults across the course of the pandemic,” says George. “Many problems will resolve but there is a possibility that some will continue, given ongoing economic disruption and unemployment. More than ever, we need research to track young parents through their pregnancies and beyond.”
“Intervention in adolescence is likely to yield benefits not only for parents’ own continuing mental health, but also for their child’s development, both by reducing the risk of premature birth and promoting positive engagement and nurturing care across the early years of life.”
He said the findings further strengthened the need for expanding preconception mental health care to both men and women, before they become parents.
The one reason why most babies see a GP
Three in four of Australian babies’ GP visits, and one in 10 emergency department visits, are because of just one reason.
That reason is an infection, most commonly a respiratory infection.
Knowing why babies are being taken to see the GP, and even taken to hospital, helps our health system to develop prevention strategies, and ensure there’s enough health resources available in baby boom areas.
MCRI’s Dr Rebecca Rowland says “infant infections place significant burden on primary health care. Quantifying this burden in the Australian setting and understanding the associated factors can help target resources and prevention efforts.”
Rebecca says that the study also identified factors that led to increased rates of infection in the first year of life. She found maternal antibiotic exposure in pregnancy, having older siblings, attending childcare, and reduced rates of breastfeeding were all associated with infant infections.
“Antibiotics are potentially life-saving for bacterial infections generally, and also in pregnancy, so the key messages are promoting appropriate antibiotic use in pregnancy, and also breastfeeding for at least the first month of life. These factors may help reduce the early life burden of infection,” she said.
Her study also showed the importance of breastfeeding for reducing the rate of infection: “On average, infants who were breastfed for at least four weeks experienced about 30 per cent fewer overall infections.”
Celebrating 2020: Creating possible, together
2020 has been a tough year for many, but the generous support of stakeholders and the commitment of our team has seen great steps towards better health for children.
At the end of November, MCRI held its Annual Showcase with the theme of Creating Possible, Together. It was an opportunity to look back at some of the highlights of 2020, to honour those who have supported our work, and recognise the teams who have worked so hard and created real change for children’s health.
At the event, attendees heard from a number of MCRI researchers celebrating some of their 2020 highlights, and from key supporters who took the chance to reflect and share their passion for delivering great outcomes for children’s health.
Watch Dr Hamish Graham on the overwhelming need for oxygen access in low and middle income countries:
See Professor Ravi Savarirayan discuss the extraordinary breakthroughs made in treatment for children with achondroplasia, the most common form of dwarfism:
Listen to Professor Sharon Goldfeld on the work she’s leading to change systems to ensure every child can have the best start to school:
Learn more about the BRACE trial, led by Professor Nigel Curtis, which is working to protect healthcare workers on three continents from COVID-19:
Hear from Professor Melissa Little on the impact of ‘mini-organ’ models for health research:
There was also the announcement of a game-changing $5 million endowment from Sarah and Lachlan Murdoch that will fund a perpetual Fellowship. The Fellowship will attract the world’s leading researchers in transformative medical research fields such as stem cell technology and genomic precision medicine.
Understanding children’s needs in the middle years
A lot happens between the ages of eight and 14 years, including puberty and the shift from primary to secondary school. Proper support is essential to help these kids to be their best.
The middle years are a time of major physical, biological, social and emotional growth said MCRI’s Dr Lisa Mundy, who has led a new study looking at the importance of the years between eight and 14 for children’s health, wellbeing and development.
“Many emotional and behavioural problems begin in the middle years” says Lisa.
“Problems with peer groups, bullying and difficulty adjusting to secondary school frequently cause further loss of learning and increase the risk of mental health problems including depression and suicide.”
“This is a sensitive and significant period that we describe as a ‘developmental switch point,’ when the impact of positive interventions, such as supporting strong peer relationships and reducing bullying, might be at their greatest.”
A new survey from MCRI researchers has shown that significant numbers of children in the middle years of childhood experience bullying, and have high rates of emotional and behavioural problems.
The research that Lisa and her team have performed identified a number of recommended changes and improvements to help these children have a successful middle childhood.
Now, MCRI’s Childhood to Adolescence Transition Study (CATS) team is using their results to work with the Commonwealth Department of Education and Training to lobby for policy changes that can ensure middle years students are better supported through these critical years.
Learn more about CATS at MCRI
COVID-19 increasing the risk of a measles infection boom
One consequence of the COVID-19 pandemic is that many children have missed out on routine vaccinations. The result is that measles could run rampant.
While 2020 has been quiet for many infectious diseases, thanks to a lack of travel and increase in social distancing, it doesn’t mean that serious childhood infections have disappeared.
In fact, Professor Kim Mulholland, from MCRI and the World Health Organization’s (WHO) SAGE Working Group on measles and rubella vaccines, said that many children have missed out on measles vaccination this year, which makes future measles outbreaks inevitable.
While measles has a reputation as mild, it can cause severe complications, including death.
Kim says that there’s another major complication too – rising malnutrition. Malnutrition worsens the severity of measles, leading to poorer outcomes and more deaths.
The economic impacts of the pandemic are likely to be particularly harsh in low and middle-income countries whose immunisation programs have been impacted. The economic fallout could push children and families there into malnutrition at a time when children do not have disease protection.
“Children who die from measles are often malnourished, but acute measles pushes many surviving children into malnutrition,” says Kim. “Malnutrition, along with measles-associated immune suppression, leads to delayed mortality, while co-existing vitamin A deficiency can also lead to measles-associated blindness.
“The coming months are likely to see increasing numbers of unimmunised children who are susceptible to measles. Many live in poor, remote communities where health systems are less resilient, and malnutrition and vitamin A deficiency are already increasing.”
Professor Mulholland says that routine immunisation services have been greatly disrupted in many countries.
The WHO estimated that delayed vaccination campaigns in 26 countries have led to 94 million children missing scheduled measles vaccine doses.
“All these factors create the environment for severe measles outbreaks in 2021, accompanied by increased death rates and the serious consequences of measles that were common decades ago,” says Kim. “This is despite the fact that we have a highly cost-effective way to prevent this disease through measles vaccination.”
“Without concerted efforts now, it is likely that the coming years will see an increase in measles and its severe, frequently fatal, complications.”
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