Sandra E. Juul, MD, PhD

Dr. Juul's research interests are focused in two primary areas:

1. Factors which impact normal neurodevelopment:
   In collaboration with Dr. Chris Gleason, Dr. Juul is investigating the acute and long-term effects of neonatal stress and its treatment with sedative and analgesic agents such as morphine and Ativan. These drugs are used commonly in the management of non-surgical ELBW babies, yet little is known about their effects on the developing brain. To study the potential effects of each factor separately as well as potential interaction effects of morphine, Ativan and stress, they have developed mouse and rat models of neonatal stress which mimic the multiple stressors experienced by preterm infants in the NICU. In projects funded by the NIH (NINDS) these models are used to study the cerebrovascular, neuropathologic, and behavioral effects of neonatal stress and neurotropic drug use.
    
2. Possible neuroprotective therapies for brain injury:
   In research funded by the NIH (Institute of Child Health and Development, and NINDS), and private foundations, the neuroprotective effects of erythropoietin (Epo) is studied in neonatal models of brain injury. Dr. Juul has identified Epo and its receptor in the developing human and rodent brain, studied the penetration of Epo across the blood brain barrier, and examined the safety and neuroprotective effects of high dose Epo in a variety of brain injury models. Her research shows that Epo protects the neonatal brain from injury due to hypoxia and oxidative injury. Dr. Juul will now be moving this research from the bench to the bedside, with phase I/II studies of both preterm and term neonates. She is also in the planning phase of a multicenter randomized clinical trial to test the efficacy of Epo in preterm infants.

Selected Publications

Jacobson Misbe EN, Richards TL, McPherson RJ, Burbacher TM, Juul SE. Perinatal asphyxia in a nonhuman primate model. Dev Neurosci. 2011;33:210-221.

Juul SE, Beyer RP, Bammler TK, Farin FM, Gleason CA. Effects of neonatal stress and morphine on murine hippocampal gene expression. Pediatr Res. 2011;69:285-292.

Nguyen-Vermillion A, Juul SE, McPherson RJ, Ledbetter DJ. Time course of C-reactive protein and inflammatory mediators after neonatal surgery. J Pediatr. 2011;159:121-126.

Beckstrom AC, Tanya P, Humston EM, et al. The perinatal transition of the circulating metabolome in a nonhuman primate. Pediatr Res. 2012;71:338-344.

Cheng CF, Zerzan JC, Johnson DB, Juul SE. Zinc protoporphyrin-to-heme ratios in high-risk and preterm infants. J Pediatr. 2012;161:81-87 e81.

Juul S. Neuroprotective role of erythropoietin in neonates. J Matern Fetal Neonatal Med. 2012;25 Suppl 4:105-107.

Juul S. Erythropoiesis and the approach to anemia in premature infants. J Matern Fetal Neonatal Med. 2012;25:97-99.

McAdams RM, McPherson RJ, Mayock DE, Juul SE. Outcomes of extremely low birth weight infants given early high-dose erythropoietin. J Perinatol. 2012.

Robertson NJ, Tan S, Groenendaal F, et al. Which neuroprotective agents are ready for bench to bedside translation in the newborn infant? J Pediatr. 2012;160:544-552 e544.

Wu YW, Bauer LA, Ballard RA, et al. Erythropoietin for neuroprotection in neonatal encephalopathy: safety and pharmacokinetics. Pediatrics. 2012;130:683-691.

Hays SL, Valieva OA, McPherson RJ, Juul SE, Gleason CA. Adult responses to an ischemic stroke in a rat model of neonatal stress and morphine treatment. Int J Dev Neurosci. 2013;31:25-29.