PORPOISE (Precision pharmacOtherapy and Risk PrOfiling in Susceptible Early-life populations)

Newborn infants can respond differently to medicines because the systems responsible for processing and responding to drugs are still developing. These differences may be particularly important in extremely preterm infants and babies with neonatal encephalopathy, who are often exposed to multiple medicines alongside critical illness and rapidly changing physiology.

PORPOISE investigates how these factors interact to influence medication-related risk. The research focuses on polypharmacy, drug-drug interactions and cumulative organ toxicity, exploring how developmental pharmacology can help explain why combinations of medicines may behave differently in newborn infants and how risk might be better anticipated and detected. Kidney injury is a particular focus, including how nephrotoxic exposures relate to acute kidney injury and whether emerging urinary biomarkers could provide earlier, neonatal-tailored indicators of drug-related toxicity.

Antimicrobials are a major contributor to neonatal medication exposure, while sepsis, inflammation and organ dysfunction may further influence drug handling and susceptibility to toxicity. Research on neonatal sepsis and precision approaches to antimicrobial stewardship therefore forms an important complementary strand. Pharmacogenomics is already beginning to inform neonatal care, but genetic information must be understood alongside developmental stage, illness and concurrent medicines. PORPOISE aims to strengthen understanding of these intersecting factors to support more individualised neonatal pharmacotherapy.

Funder

PhD fee support provided through funding held by Prof. Cristín Ryan, School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin.

Research Team & Collaborators

Laura Johnson – PhD Researcher
Prof. Cristín Ryan – PhD Supervisor, School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin
Prof. Eleanor Molloy – PhD Supervisor, Discipline of Paediatrics, School of Medicine, Trinity College Dublin