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 has now moved this research from the bench to the bedside, with phase I/II studies of both ELBW preterm infants and term neonates with hypoxic-ischemic brain injury. She is also in the planning phase of a multicenter randomized clinical trial to test the efficacy of Epo in preterm infants.