Employing New Technologies in Fetal and Placental Studies
The Center for Fetal and Placental Research combines basic and translational research to understand the cause of congenital and genetic disorders and develop novel treatments for these conditions.
Our team studies fetal surgery, gene therapy and the use of a synthetic amniotic fluid during interventions to improve care. In addition, we strive to learn more about the role of amniotic fluid and the placenta in development.
Many opportunities exist to collaborate on new fetal therapies. We work closely with other labs and divisions throughout Cincinnati Children’s and the University of Cincinnati (UC), including Bioengineering, Human Genetics, Neonatology, Immunobiology, Neurosurgery and Pulmonology. For example, experts in the center are working with engineering colleagues to create nanovesicles that can deliver targeted gene therapies.
Our Research
Fortunately, many diseases and fetal abnormalities now can be prenatally diagnosed through genetic testing and imaging techniques. In some cases, treatment during pregnancy is an option. With collaborative research we aim to create therapies for those conditions with no current interventions.
We study gene therapy, which is the use of viral vectors to deliver missing genes or gene products through the blood stream or into brain ventricles. The fetal environment is unique due to the developing tissues and immune system. This means:
- The fetal blood-brain barrier is not fully developed.
- The fetus immune system does not produce the same antibody response as an adult.
If we can introduce gene therapy in utero, we may reverse the condition. We may also create opportunities for additional treatments after birth because of exposure of the gene therapy to the developing immune system. With many gene therapies already in use, we believe it’s only a matter of time before we can deliver such treatments to a fetus.
As we learn how amniotic fluid directs development of the lungs and gastrointestinal tract, we are optimizing synthetic amniotic fluid. Developed at Cincinnati Children’s, the Amniowell synthetic fluid reduces membrane inflammation and supports lung development. Researchers hope to commercialize the synthetic fluid soon so it can be used during fetal procedures and surgeries.
We also study the drivers of inflammation in the placenta and placental membranes that are frequently observed during preterm birth. This placental inflammation is a major cause of adverse neonatal development as inflammatory factors are secreted in the amniotic fluid and expose the unborn baby to inflammation with subsequent effects on gut, lung and brain development. Defining possible microbial or immune rejection events in the inflamed placental tissue will aid in the design of therapeutics to limit or prevent placental inflammation and neonatal exposure.
We've also created new technology to treat fetal hydrocephalus. Developed in pre-clinical models, we use endoscopic surgery to release brain pressure during development. The goal of the procedure is to stop ongoing damage to the fetal brain caused by the high pressure rather than waiting until birth. We are working to start clinical trials.
Research Funding
The fetal and placental scientists at Cincinnati Children’s are highly successful at building grant support for their work and publishing their results in top scientific journals. Our research team and faculty members secure funding from many organizations, including government agencies such as the National Institutes of Health, public and private foundations and academic societies.
Training, Planning for the Future
The Fetal Care Center supports research, education and training by giving faculty the resources and support to understand the cause of fetal anomalies and find ways to reverse or treat them.
Our labs are staffed by fellows, postdoctoral, graduate and medical students and specialized research assistants.
We also partner with faculty doing clinical research studies in fetal and placental medicine.
We are keen to explore new methods. In our effort to treat congenital conditions, we are employing nanoparticles to deliver therapy. In one model for a lung condition, we inject a fetus with an infusion that travels to the lungs. This could be a way to correct genetic abnormalities on an organ-specific level. Ongoing translational human studies investigate: 1. The drivers of placental inflammation in preterm birth and 2. The effects of placental inflammation on neonatal development.
