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Sandra E. Juul, MD, PhD

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Sandra E. Juul, MD, PhD

Neonatology

On staff since July 2000

Children's Title: Director, Neonatology Fellowship

Academic Title: Professor of Pediatrics

Research Center: Center for Integrative Brain Research

"As a neonatologist, I am privileged to participate in the care of the most precious, fragile individuals. These small patients and their families often humble me with their insights and endurance in the face of great adversity. I believe that my role as an academic neonatologist is to bring the field forward by focusing on specific clinical problems and through research efforts, try to solve or shed light on them. My research focuses on neonatal neuroprotection: how to protect the brain from injury, and how to repair the injured brain."

Overview

Board Certification(s)
Pediatrics
Neonatal-Perinatal Medicine
Medical/Professional School
University of Washington School of Medicine, Seattle
University of Chicago, Chicago
Residency
Pediatrics, University of Washington School of Medicine, Seattle
Fellowship
Neonatal-Perinatal Medicine, Seattle Children's Hospital, Seattle
Clinical Interests

Non-hematopoietic effects of erythropoietin (Epo), particularly its neuroprotective effects. Hematopoiesis and iron balance in preterm infants are additional areas of interest and research.

Research Description

Recombinant erythropoietin (rEpo) has been used since 1989 as an erythropoietic agent in adults and children. More recently, Epo effects have been recognized in tissues other than bone marrow. Functional receptors for Epo are present in the developing brain, liver, heart, blood vessels, and intestine.

During development, endogenous Epo acts as a general trophic and anti-apoptotic factor. Mechanisms of Epo action are being investigated. Two promising areas of research include the use of rEpo to prevent or ameliorate necrotizing enterocolitis, and the use of rEpo to decrease brain damage following injury such as perinatal hypoxia-ischemia.

Using a variety of molecular biology, cell and tissue culture techniques, and in vivo models, Dr. Juul's research is focused on determining the effects of Epo on neurodevelopment, neuroprotection, intestinal development, and intestinal injury. Additional areas of interest include neonatal hematology, and iron deficiency in the developing neonate.

Research Focus Area

Neuroscience / Neurodevelopment

Publications

Adult responses to an ischemic stroke in a rat model of neonatal stress and morphine treatment.
International journal of developmental neuroscience : the official journal of the International Society for Developmental Neuroscience , 2013 Feb: 31(1)25-9
Hypothermia plus erythropoietin for neonatal neuroprotection? Commentary on Fan et al. and Fang et al.
Pediatric research , 2013 Jan: 73(1)10-1
Erythropoietin for neuroprotection in neonatal encephalopathy: safety and pharmacokinetics.
Pediatrics , 2012 Oct: 130(4)683-91
Neuroprotective role of erythropoietin in neonates.
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians , 2012 Oct: 25 Suppl 4105-7
Erythropoietin in anemia of prematurity.
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians , 2012 Oct: 25(Suppl 5)80-4
Erythropoiesis and the approach to anemia in premature infants.
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians , 2012 Oct: 25(Suppl 5)97-9
Zinc protoporphyrin-to-heme ratios in high-risk and preterm infants.
The Journal of pediatrics , 2012 Jul: 161(1)81-7.e1
Cell therapy for neonatal hypoxia-ischemia and cerebral palsy.
Annals of neurology , 2012 May: 71(5)589-600
The perinatal transition of the circulating metabolome in a nonhuman primate.
Pediatric research , 2012 Apr: 71(4 Pt 1)338-44
Which neuroprotective agents are ready for bench to bedside translation in the newborn infant?
The Journal of pediatrics , 2012 Apr: 160(4)544-552.e4
Long-term effects of neonatal stress on adult conditioned place preference (CPP) and hippocampal neurogenesis.
Behavioural brain research , 2012 Feb 1: 227(1)7-11
The role of cytokines and inflammatory cells in perinatal brain injury.
Neurology research international , 2012: 2012561494
Hypothermia and other treatment options for neonatal encephalopathy: an executive summary of the Eunice Kennedy Shriver NICHD workshop.
The Journal of pediatrics , 2011 Nov: 159(5)851-858.e1
Time course of C-reactive protein and inflammatory mediators after neonatal surgery.
The Journal of pediatrics , 2011 Jul: 159(1)121-6
Application of comprehensive two-dimensional gas chromatography with time-of-flight mass spectrometry method to identify potential biomarkers of perinatal asphyxia in a non-human primate model.
Journal of chromatography. A , 2011 Apr 8: 1218(14)1899-906
Effects of neonatal stress and morphine on murine hippocampal gene expression.
Pediatric research , 2011 Apr: 69(4)285-92
Perinatal asphyxia in a nonhuman primate model.
Developmental neuroscience , 2011: 33(3-4)210-21
Left ventricular hypertrophy is prevalent in Sprague-Dawley rats.
Comparative medicine , 2010 Oct: 60(5)357-63
Erythropoietin: not just about erythropoiesis.
Lancet , 2010 Jun 19: 375(9732)2142
Erythropoietin for infants with hypoxic-ischemic encephalopathy.
Current opinion in pediatrics , 2010 Apr: 22(2)139-45
High-dose erythropoietin does not exacerbate retinopathy of prematurity in rats.
Pediatric research , 2009 Dec: 66(6)625-30
Postnatal stress produces hyperglycemia in adult rats exposed to hypoxia-ischemia.
Pediatric research , 2009 Sep: 66(3)278-82
Effects of transfusions in extremely low birth weight infants: a retrospective study.
The Journal of pediatrics , 2009 Sep: 155(3)331-37.e1
Microarray analysis of high-dose recombinant erythropoietin treatment of unilateral brain injury in neonatal mouse hippocampus.
Pediatric research , 2009 May: 65(5)485-92
Resident duty hour restrictions: is less really more?
The Journal of pediatrics , 2009 May: 154(5)631-632.e1
Neonatal stress or morphine treatment alters adult mouse conditioned place preference.
Neonatology , 2009: 95(3)230-9
Effects of neonatal stress and morphine on kappa opioid receptor signaling.
Neonatology , 2009: 96(4)235-43
A phase I/II trial of high-dose erythropoietin in extremely low birth weight infants: pharmacokinetics and safety.
Pediatrics , 2008 Aug: 122(2)383-91
Recent trends in erythropoietin-mediated neuroprotection.
International journal of developmental neuroscience : the official journal of the International Society for Developmental Neuroscience , 2008 Feb: 26(1)103-11
Characterization of developing bowel transplanted from transgenic erythropoietin receptor-deficient mouse embryos.
Neonatology , 2008: 93(1)56-63
Recombinant erythropoietin is neuroprotective in a novel mouse oxidative injury model.
Developmental neuroscience , 2008: 30(4)231-42
High-dose erythropoietin inhibits apoptosis and stimulates proliferation in neonatal rat intestine.
Growth hormone & IGF research : official journal of the Growth Hormone Research Society and the International IGF Research Society , 2007 Oct: 17(5)424-30
Epo and other hematopoietic factors.
Seminars in fetal & neonatal medicine , 2007 Aug: 12(4)250-8
Pharmacokinetics of high-dose recombinant erythropoietin in plasma and brain of neonatal rats.
Pediatric research , 2007 Jun: 61(6)671-5
A comparison of high-dose recombinant erythropoietin treatment regimens in brain-injured neonatal rats.
Pediatric research , 2007 Apr: 61(4)451-5
Safety of high-dose recombinant erythropoietin in a neonatal rat model.
Neonatology , 2007: 91(1)36-43
A new model of neonatal stress which produces lasting neurobehavioral effects in adult rats.
Neonatology , 2007: 92(1)33-41
Prenatal cord clamping in newborn Macaca nemestrina: a model of perinatal asphyxia.
Developmental neuroscience , 2007: 29(4-5)311-20
Iron sulfate supplementation decreases zinc protoporphyrin to heme ratio in premature infants.
The Journal of pediatrics , 2006 Jan: 148(1)44-8
Erythropoietin protects dopaminergic neurons and improves neurobehavioral outcomes in juvenile rats after neonatal hypoxia-ischemia.
Pediatric research , 2005 Aug: 58(2)297-301
Patterns of thrombocytosis and thrombocytopenia in hospitalized neonates.
Journal of perinatology : official journal of the California Perinatal Association , 2005 Mar: 25(3)166-72
Evaluation of eosinophilia in hospitalized preterm infants.
Journal of perinatology : official journal of the California Perinatal Association , 2005 Mar: 25(3)182-8
Evaluation of neutropenia and neutrophilia in hospitalized preterm infants.
Journal of perinatology : official journal of the California Perinatal Association , 2004 Mar: 24(3)150-7
Recombinant erythropoietin as a neuroprotective treatment: in vitro and in vivo models.
Clinics in perinatology , 2004 Mar: 31(1)129-42
Erytropoietin concentrations in cerebrospinal fluid of nonhuman primates and fetal sheep following high-dose recombinant erythropoietin.
Biology of the neonate , 2004: 85(2)138-44
Effect of recombinant granulocyte colony-stimulating factor on blood neutrophil concentrations among patients with "idiopathic neonatal neutropenia": a randomized, placebo-controlled trial.
Journal of perinatology : official journal of the California Perinatal Association , 2003 Sep: 23(6)493-7
Enterally dosed recombinant human erythropoietin does not stimulate erythropoiesis in neonates.
The Journal of pediatrics , 2003 Sep: 143(3)321-6
Absorption of enteral recombinant human erythropoietin by neonates.
The Annals of pharmacotherapy , 2003 Jun: 37(6)782-6
Zinc protoporphyrin/heme as an indicator of iron status in NICU patients.
The Journal of pediatrics , 2003 Mar: 142(3)273-8
The effect of interleukin-1beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha) on granulocyte macrophage-colony stimulating factor (GM-CSF) production by neuronal precursor cells.
European cytokine network , 2002 Jan-Mar: 13(1)128-33

Primary Office

University of Washington
UW Box 356320 - Neonatology
1959 NE Pacific St
Seattle, WA 98195-6320
206-543-3200

Additional Offices

Seattle Children's
M-112 - NICU Administration
4800 Sand Point Way NE
Seattle, WA 98105
206-987-2041

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