Researchers on the trail of the causes of SIDS

"We will try to detect a biomarker in urine that will allow to warn sufficiently early that a child is at risk of sudden cot death" - explained Dr. Paweł Szczęsny PAP from the Institute of Biochemistry and Biophysics PAS in an interview with PAP. For the implementation of this research project, the scientist received a grant from the project LEADER of the National Centre for Research and Development.

The mechanism of sudden infant death syndrome (SIDS) is not yet completely understood. "In the West, sudden cot death is diagnosed by ruling out any other reasons for which the child could have died. Although the dominant hypothesis about the causes of SIDS appears to be an irregularity in the development of the nervous system, we, as well as several other teams abroad, believe that SIDS has metabolic causes. It is - in our opinion - a string of unfortunate coincidences that lead to the child falling asleep, and the parent finding it dead" - said Dr. Szczęsny. He added that this string of coincidences can be reduced to a single common mechanism that stops the diaphragm, the main breathing muscle.

"Sudden infant death syndrome is sudden for parents. But all indications are that the metabolic changes that lead to this sudden event, are taking place earlier. Our preliminary results imply that SIDS can be predicted with 24-48 hours advance" - reported the biologist.

The risk of SIDS - the scientist hopes - may be determined by detecting a characteristic combination of chemical compounds in child’s urine. "The most obvious idea is to design a simple chemical marker that could be added as an ingredient to disposable diapers. If a parent sees that the diaper has changed its colour, it will signal that instead of putting the baby to sleep, it should be taken for medical examination. Doctor will decide when and how to counter the threat" - noted the winner of LEADER program.

The researcher explained that the associations of SIDS with infections, overheating, exposure to tobacco smoke, wrong position during sleep and with low birth weight had been observed. "All these factors not so much as cause SIDS, but rather disrupt the homeostasis of the body (and thus knock the body out of balance - PAP). I was very surprised when I found out that these factors disturb homeostasis virtually in the same way" - commented the researcher from the Institute of Biochemistry and Biophysics PAS.

According to the researcher, low birth weight, infections, smoke, abnormal position may lead to phosphate management disorders in the body. Unfortunately, a baby can not make up for the shortage of phosphates, like older children and adults do. "We have a huge supply of phosphates in the bones, babies - not yet" - said the scientist.

Meanwhile, the phosphates in the body are a component of ATP - the main fuel of cells, the substance each cell needs to live. A muscle extremely sensitive to the shortage of ATP is the diaphragm. When its cells do not have enough energy to work, the diaphragm just stops. The fact that the infant’s diaphragm runs out of energy may result from various factors. Dr. Szczęsny explained that ATP can, for example, be consumed by the immune system to combat infection in the upper respiratory tract or harmful substances from cigarette smoke. In addition, the supply of phosphate in bone is much smaller in the body of children with low birth weight. Incorrect (from the viewpoint of the current SIDS prevention guidelines) sleep position (on the belly) may force the diaphragm to work harder, which also translates into increased energy demand.

The biologist suggests that in the case of detection of risk of sudden cot death, the doctor could, for example, decide to supplement the shortage of phosphate in the body. For now, however, these are only hypotheses that need to be confirmed in studies.

SIDS is the number one cause of death in babies born healthy in civilized countries. According to various estimates, it happens once in few thousand, or ten thousand live births. "For Poland this would mean tens-hundreds of deaths each year. In our country, however, there is no systematic diagnosis of cot death syndrome" - commented the researcher.

PAP - Science and Scholarship in Poland, Ludwika Tomala

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