# Targeted Therapies for Neonatal White Matter Injury

> **NIH NIH R01** · HUGO W. MOSER RES INST KENNEDY KRIEGER · 2020 · $413,550

## Abstract

PROJECT SUMMARY ABSTRACT
Neonatal White Matter Injury (NWMI) is the leading cause of neurologic and developmental disabilities in
children born prematurely. Neuroinflammation, following an initial ischemic/hypoxic-ischemic or infectious
insult, mediated by activated microglia and astrocytes, is implicated in the pathogenesis resulting in diffuse
white matter injury. Targeted drug delivery to attenuate neuroinflammation may greatly improve therapeutic
outcomes. However, delivery of drugs for the treatment of diffuse brain injury in the neonate is a major
challenge. Our preliminary studies suggest that intravenous administration of dendrimers (tree-like
nanostructured polymers, 4 nm) results in their selective accumulation in activated microglia/macrophages and
astrocytes in the brain of injured animals. Importantly, a single, intravenous 10 mg/kg dose of N-acetyl cysteine
(NAC) conjugated to the dendrimer (D-NAC), administered after neonatal ischemia resulted in a significant
improvement in myelination in the short-term, and attenutation of neuroinflammation. First, we seek to
attenuate neuroinflammation in NWMI in a targeted manner. However, target drug delivery for the treatment of
diffuse brain injury is a major challenge. We have previously shown that systemic administration of dendrimers
(tree-like nanostructured polymers, 4nm) results in their selective accumulation in activated microglia and
astrocytes, and in oligodendrocytes in our ischemic NWMI mouse model. Furthermore, dendrimer conjugated
to N-acetylcysteine (D-NAC), systemically administered at 24h and 5 days post neonatal ischemia, resulted in
sustained attenuation of inflammatory cytokines and reduction of white matter injury at postnatal day 14.
Second, we seek to use targeted D-NAC nanotherapy to improve Glial restricted precursor (GRP) survival.
GRP cell transplantation is currently being investigated as a therapeutic strategy in a number of neurologic
diseases, and we have previously shown that transplanted GRPs exert some restorative effect in the same
ischemic mouse model of NWMI, but have limited survival and differentiation capacity when injected into
injured brain. Building on these promising findings, the objective of this application is to (i) provide sustained
drug release by D-NAC to prolong therapeutic effect, (ii) determine the therapeutic window for D-NAC
treatment in the postnatal period and (iii) determine whether D-NAC can enhance survival and restorative
capacity of transplanted GRP cells. Our hypotheses are that (1) ongoing neuroinflammation will facilitate
selective accumulation of D-NAC in activated microglia/macrophages and astrocytes even at later time points
following neonatal ischemia in NWMI; (2) Targeted cellular delivery and sustained release of NAC by
dendrimer nanodevices will result in (a) reduction of neuroinflammation/oxidative stress, and (b) improve long
term neurobehavioral and neuropathological outcomes in NWMI; (3) D-NAC therapy will reduce in...

## Key facts

- **NIH application ID:** 9916819
- **Project number:** 5R01NS097511-05
- **Recipient organization:** HUGO W. MOSER RES INST KENNEDY KRIEGER
- **Principal Investigator:** S. Ali Fatemi
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $413,550
- **Award type:** 5
- **Project period:** 2016-07-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9916819

## Citation

> US National Institutes of Health, RePORTER application 9916819, Targeted Therapies for Neonatal White Matter Injury (5R01NS097511-05). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9916819. Licensed CC0.

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