Pomegranate juice may prevent newborn brain injuries

Expectant mothers at risk for premature birth may want to consider drinking pomegranate juice to help their babies resist brain injuries from low oxygen and reduced blood flow, according to a School of Medicine mouse study.

In humans, decreased blood flow and oxygen to the infant brain is linked to premature birth and other irregularities during pregnancy, birth and early development.

The phenomenon, called hypoxia ischemia, causes brain injury in approximately two of every 1,000 full-term human births, and in a very high percentage of babies born before 34 weeks of gestation.

Hypoxic ischemic brain injury can lead to seizures, a degenerative condition known as hypoxic ischemic encephalopathy and mobility impairments, including cerebral palsy.

When scientists temporarily lowered brain oxygen levels and brain blood flow in newborn mice whose mothers drank water mixed with pomegranate concentrate, newborn brain tissue loss was reduced by 60 percent in comparison with newborn mice whose mothers drank sugar water or other fluids.

“Hypoxic ischemic brain injury in newborns is very difficult to treat, and right now there’s very little we can do to stop or reverse its consequences,” said the study’s senior author, David M. Holtzman, M.D., the Andrew B. and Gretchen P. Jones Professor and head of the Department of Neurology. “Most of our efforts focus on stopping it when it happens, but if we could treat everyone who’s at risk preventively, we may be able to reduce the impacts of these kinds of injuries.”

The study, which appeared in the June issue of Pediatric Research, was conducted in collaboration with POM Wonderful, a U.S. producer of pomegranates and pomegranate juice, and scientists at the University of California, Los Angeles.

Lead author David Loren, M.D., formerly a neonatal critical care fellow at Washington University, performed the research. He is now at the University of Washington.

Holtzman’s team has been studying neonatal brain injury for more than a decade by temporarily reducing oxygen levels and blood flow in the brains of 7-day-old mice and rats.

The model produces brain injuries similar to those seen in human infants injured by hypoxia ischemia.

Pomegranates contain very high concentrations of polyphenols, substances also found in grapes, red wine and berries, which scientists have linked to potential neuroprotective and anti-aging effects.

Scientists gave pregnant female mice water with pomegranate juice, plain water, sugar water or vitamin C water to drink during the last trimester of pregnancy and while they suckled newborns for seven days after birth.

After performing the procedures that exposed infant mice to low oxygen levels, scientists examined the brains, comparing damage to the cortex, hippocampus and the striatum.

Researchers who conducted the examinations were unaware which fluid the pregnant mice drank.

Mice whose mothers drank pomegranate juice had brain injuries less than half the size of those found in other mice.

Much of the damage from hypoxia ischemia results when oxygen-starved brain cells self-destruct via a process known as apoptosis.

Scientists found an enzyme linked to apoptosis, called caspase-3, was 84 percent less active in mice whose mothers drank pomegranate juice.

Holtzman said the results suggest the need for studies of pomegranate juice’s effects in humans, but he cautions that because of the relative unpredictability of hypoxia ischemia in newborns, it would be difficult to assemble a sufficiently large study group.

Hypoxic ischemic brain damage is frequently associated with premature delivery. The lungs, brain and circulatory systems in some premature babies are insufficiently mature to supply the brain with enough nutrients and oxygen outside the womb.

Scientists know some of the factors that increase risk of premature birth, including diabetes, low economic status, youthful mothers, weakness in the cervix and a personal or familial history of miscarriage.

“One might advise this group that studies in animals have suggested drinking pomegranate juice may reduce the risk of injury from hypoxia ischemia,” Holtzman said.

The team’s findings and other research into the potentially beneficial effects of pomegranate juice, red wine and other natural foods form a neurological parallel to chemoprevention, an area of oncology research focused on finding naturally occurring substances in foods that reduce the chances of developing cancer.

“For pregnant women previously interested in the neuroprotective effects of red wine, these results suggest that pomegranate juice may provide an alternative during pregnancy, when alcohol consumption is unacceptable because it increases the risk of birth defects,” said Holtzman, also the Charlotte and Paul Hagemann Professor of Neurology and Molecular Biology and Pharmacology.

Holtzman’s group is attempting to isolate the neuroprotective ingredients in pomegranate juice as a possible prelude to concentrating those ingredients and testing their ability to reduce brain injury.

The team also plans to investigate the possibility that polyphenols from pomegranates and other natural foods can slow neurological disorders such as Alzheimer’s disease.