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Collaborative Studies in Fetal Development Robin Ohls, MD Department of Pediatrics

Collaborative Studies in Fetal Development Robin Ohls, MD Department of Pediatrics. Infants born prematurely suffer from numerous problems affecting every organ system

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Collaborative Studies in Fetal Development Robin Ohls, MD Department of Pediatrics

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  1. Collaborative Studies in Fetal DevelopmentRobin Ohls, MDDepartment of Pediatrics • Infants born prematurely suffer from numerous problems affecting every organ system • Premature adaptation from the in utero environment to the extra-uterine environment creates significant developmental stressors which are managed differently by each system • Blood (AoP) • GI System (NEC) • Eye (ROP) • Heart (PDA)

  2. Developing GI Tract and NEC: Necrotizing Enterocolitis Life threatening GI disease in preterm infants Involves severe inflammatory response to mucosal injury Cause of NEC is unknown; thought to be due to ischemia, bacterial invasion, and increased gut response to inflammatory cells mucosal tolerance to bacterial products developmentally regulated, deficient in the preterm intestine TGF-b2attenuates macrophage inflammatory responses in the developing intestine In collaboration with Akhil Maheshwari, University of Alabama-Birmingham

  3. vitreous serum 1 2 Epo mU/mL 3 Weeks gestation Stage 3 ROP Vascular Growth in Developing Eye: Retinopathy of Prematurity Vascular overgrowth/scarring of the retina that occurs during maturation Associated risk factors for development of ROP: prematurity Hyperoxia/hypoxia Prevention of ROP might include evaluation of vascular growth factors such as Epo or VEGF Measure of vascular growth factors in developing human eye In collaboration with Shrena Patel, University of Utah

  4. 3 mm Aorta Right PA Pulm. trunk Ductus Arteriosus Left PA Developing Circulation and PDA: Patent Ductus Arteriosus Ductus arteriosus allows for in utero communication between the pulmonary artery and the aorta; major morbidity for preterm infants if it persists after birth Link between Epo administration and PDA closure Epo stimulates Endothelin production Epo receptors present in fetal sheep DA; receptor number increases with increasing gestation What role do Epo receptors and other vascular growth factor receptors play in developing human DA? In collaboration with Ron Clyman, UCSF

  5. Other Projects • Vascular growth factors involved in fetal skin development and wound healing (Epo, VEGF, PPARg, PGC-1) • Impact of early CMV infection on developing brain inflammatory cells and developing cochlear cells • Identification of Rh positive and negative fetuses through measurement of fetal DNA in maternal circulation • Endothelial progenitor cells in the developing circulation

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