Prospects of intrauterine treatment of inflammatory changes of enteric organs in gastroschisis in fetuses, in experimental conditions (literature review)
DOI:
https://doi.org/10.15574/PP.2023.96.114Keywords:
gastroschisis, fetus, intestinal lesions, mesenchymal stem cells, experimental cell therapy in animal modelsAbstract
Gastroschisis (GS) - is one of the most severe defects of newborns, which is characterized by congenital eventration of the abdominal organs outside the anterior abdominal wall into the amniotic fluid, due to a through defect of the anterior abdominal wall. The defect is adjacent to the normal, unaltered umbilical cord, usually to the right of the umbilicus, the umbilical ring is split, the eventrated organs are not covered by embryonic membranes or their remains. The frequency of gastroschisis is 0.31-4.72 per 10,000 births. Although, with the development of modern surgical approaches over the past 15 years, the mortality of newborns with gastroschisisis dynamically decreasing, however, this pathology remains a significant problem in neonatal and pediatric surgery, as it requires early surgery, associated with a significant risk of disability in children due to short bowel syndrome, abdominal cancer and recurrent esophageal disease, adhesive intestinal obstruction, etc.
Purpose - to analyze, according to the literature, the prospects for the use of cellular technologies for the in utero treatment of inflammatory changes in the enteric organs in fetal GS in experimental conditions.
The main reason for the unsatisfactory results of GS treatment is the pathological changes of the eventrated organs and their consequences. Therefore one of the ways to reduce mortality in GS is intrauterine treatment and the prevention of inflammatory changes of the eventrated organs in the fetuses. Modern regenerative medicine offers several new approaches for the treatment of fetal malformations, including the use of cell technology. Stem cells, from various sources, are one of the alternative therapies that can inhibit inflammatory processes in tissues, activate endogenous reparative mechanisms, and, ultimately, together with the implementation of preventive measures, reduce perinatal mortality and disability.
The availability of domestic cell drugs, the development of technologies for their transplantation, and methods of delivery of pregnant women with GS in the fetus, with proven clinical efficacy, will significantly improve the comprehensive treatment of patients with congenital malformations, which is significant social and economic importance. Therefore, the study of regenerative potential and assessment of the prospects for the use of stem cells in obstetrics and perinatal medicine from various sources is of great scientific and practical interest.
No conflict of interests was declared by the authors.
References
Andrzejewska A et al. (2019, Jul). Concise Review: Mesenchymal Stem Cells: From Roots to Boost. Stem Cells. 37(7): 855-864. https://doi.org/10.1002/stem.3016; PMid:30977255 PMCid:PMC6658105
Baerg J et al. (2003). Gastroschisis: A sixteen-year review. J Pediatr Surg. 38(5): 771-774. https://doi.org/10.1016/jpsu.2003.50164; PMid:12720191
Bittencourt D et al. (2006). Impact of corticosteroid of intestinal injury in a gastroschisis rat model: a morphometric analysis. J Pediatr Surg. 41(3): 547-553. https://doi.org/10.1016/j.jpedsurg.2005.11.050; PMid:16516633
Chalphin A et al. (2020). Donor mesenchymal stem cell kinetics after transamniotic stem cell therapy (TRASCET) in a rodent model of gastroschisis. J Pediatr Surg. 55(3): 482-485. https://doi.org/10.1016/j.jpedsurg.2019.11.005; PMid:31813581
Chalphin A et al. (2020). A comparison between placental and amniotic mesenchymal stem cells in transamniotic stem cell therapy for experimental gastroschisis. J Pediatr Surg. 55: 49-53. https://doi.org/10.1016/j.jpedsurg.2019.09.049; PMid:31711742
Chang C et al. (2006). Placenta-derived multipotent cells exhibit immunosuppressive properties that are enhanced in the presence of interferon-gamma. Stem Cells. 24: 2466-2467. https://doi.org/10.1634/stemcells.2006-0071; PMid:17071860
Chen Y et al. (2017). Fetal surgical repair with placenta-derived mesenchymal stromal cell engineered patch in a rodent model of myelomeningocele. J Pediatr Surg. S0022-3468(17)30662-0. https://doi.org/10.1016/j.jpedsurg.2017.10.040; PMid:29096888
Dominici M et al. (2006). Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement. Cytotherapy. 8(4): 315-317. https://doi.org/10.1080/14653240600855905; PMid:16923606
Eklad-Nordberg A et al. (2020). Prenatal stem cell therapy for inherited diseases: Past, present, and future treatment strategies. Stem Cells Transl Med. 9: 148-157. https://doi.org/10.1002/sctm.19-0107; PMid:31647195 PMCid:PMC6988764
Fauza D. (2018). Transamniotic stem cell therapy: a novel strategy for the prenatal management of congenital anomalies. Pediatr Res. 83(1-2): 241-248. https://doi.org/10.1038/pr.2017.228; PMid:28915235
Feng C et al. (2016). Transamniotic stem cell therapy (TRASCET) mitigates bowel damage in a model of gastroschisis. J Pediatr Surg. 51(1): 56-61. https://doi.org/10.1016/j.jpedsurg.2015.10.011; PMid:26548631
Feng C et al. (2017). Transamniotic stem cell therapy (TRASCET) in a leporine model of gastroschisis. J Pediatr Surg. 52: 30-34. https://doi.org/10.1016/j.jpedsurg.2016.10.016; PMid:27836365
Galganski L et al. (2019, Oct 21). In Utero Treatment of Myelomeningocele with Placental Mesenchymal Stromal Cells - Selection of an Optimal Cell Line in Preparation for Clinical Trials. J Pediatr Surg. S0022-3468(19)30681-5.
Graham C et al. (2017). Donor mesenchymal stem cells home to maternal wounds after transamniotic stem cell therapy (TRASCET) in a rodent model. J Pediatr Surg. 52: 1006-1009. https://doi.org/10.1016/j.jpedsurg.2017.03.027; PMid:28363468
Hakguder G et al. (2011). Induction of fetal diuresis with intraamniotic furosemide injection reduces intestinal damage in a rat model of gastroschisis. Eur J Pediatr Surg. 21(3): 183-187. https://doi.org/10.1055/s-0031-1271708; PMid:21341178
Hyun I. (2010, Jan 4). The bioethics of stem cell research and therapy. J Clin Invest. 120(1): 71-75. https://doi.org/10.1172/JCI40435; PMid:20051638 PMCid:PMC2798696
Kabagambe S et al. (2017). Placental Mesenchymal Stromal Cells Seeded on Clinical Grade Extracellular Matrix Improve Ambulation in Ovine Myelomeningocele. Journal of Pediatric Surgery. 53; 1: 178-182. https://doi.org/10.1016/j.jpedsurg.2017.10.032; PMid:29122293
Lankford L et al. (2017). Manufacture and preparation of human placenta-derived mesenchymal stromal cells for local tissue delivery. Cytotherapy. 19(6): 680-688. https://doi.org/10.1016/j.jcyt.2017.03.003; PMid:28438482
Lankford L et al. (2019). Stem cell-based in utero therapies for spina bifida: implications for neural regeneration. Neural Regen Res. 14(2): 260-261. https://doi.org/10.4103/1673-5374.244786; PMid:30531007 PMCid:PMC6301160
Li X et al. (2016). Application potential of bone marrow mesenchymal stem cell (BMSCs) based tissue-engineering for spinal cord defect repair in rat fetuses with spina bifida aperta. J. Mater. Sci. Mater. Med. 27(4): 77. https://doi.org/10.1007/s10856-016-5684-7; PMid:26894267 PMCid:PMC4760996
Liechty K et al. (2000). Human mesenchymal stem cells engraft and demonstrate site-specific differentiation after in utero transplantation in sheep. Nature. Medicine. 6(11): 1282-1286. https://doi.org/10.1038/81395; PMid:11062543
Mackenzie T et al. (2002). Engraftment of bone marrow and fetal liver cells after in utero transplantation in MDX mice. Journal of Pediatric Surgery. 37(7): 1058-1064. https://doi.org/10.1053/jpsu.2002.33844; PMid:12077771
Mackenzie T, Flake A. (2001). Multilineage differentiation of human MSC after in utero transplantation. Cytotherapy. 3(5): 403-405. https://doi.org/10.1080/146532401753277571; PMid:11953022
Malek A, Bersinger N. (2011). Human placental stem cells: biomedical potential and clinical relevance. J Stem Cells. 6(2): 75-92.
Mastrolia I et al. (2019). Challenges in Clinical Development of Mesenchymal Stromal/Stem Cells: Concise Review. Stem Cells Transl Med. 8(11): 1135-1148. https://doi.org/10.1002/sctm.19-0044; PMid:31313507 PMCid:PMC6811694
Montagnani S et al. (2016). Adult Stem Cells in Tissue Maintenance and Regeneration. Stem Cells Int. 2016: 7362879. https://doi.org/10.1155/2016/7362879; PMid:26949400 PMCid:PMC4754501
Nichol P et al. (2004). Meconium staining of amniotic fluid correlates with intestinal peel formation in gastroschisis. Pediatric Surgery International. 20(3): 211-214. https://doi.org/10.1007/s00383-003-1050-1; PMid:15083327
Nitkin C, Bonfield T. (2017). Concise Review: Mesenchymal Stem Cell Therapy for Pediatric Disease: Perspectives on Success and Potential Improvements. Stem Cell Transl Med. 6: 539-565. https://doi.org/10.5966/sctm.2015-0427; PMid:28191766 PMCid:PMC5442806
Oliveira M, Barreto-Filho J. (2015, May 26). Placental-derived differentiation and challenges. World J Stem Cells. 7(4): 769-775. https://doi.org/10.4252/wjsc.v7.i4.769; PMid:26029347 PMCid:PMC4444616
Pittenger M et al. (2019, Dec 2). Mesenchymal cell perspective: cell biology to clinical progress. NPJ Regen Med. 4: 22. https://doi.org/10.1038/s41536-019-0083-6; PMid:31815001 PMCid:PMC6889290
Shieh H et al. (2018). Fetal bone marrow homing of donor mesenchymal stem cell therapy (TRASCET), J Pediatr Surg. 53: 174-177. https://doi.org/10.1016/j.jpedsurg.2017.10.033; PMid:29132800
Shieh H. et al. (2019). Transamniotic stem cell therapy (TRASCET) in a rabbit model of spina bifida. J. Pediatr Surg. 54: 293-296. https://doi.org/10.1016/j.jpedsurg.2018.10.086; PMid:30518492
Sliepov O, Migur M, Ponomarenko O et al. (2018). The Impact of Eventerated Organs Status on the Clinical Course and Prognosis of Simple Gastroshisis. Sovremennaya pediatriya. 1(89): 97-102. https://doi.org/10.15574/SP.2018.89.97
Sliepov OK, Grasyukova NI, Veselskyi VL. (2014). The results of «first minutes surgery» in the treatment of gastroschisis. Peritanologiya i Pediatriya. 4(60): 18-23. https://doi.org/10.15574/PP.2014.60.18
Sliepov OK, Migur MY, Ponomarenko OP. (2021). Method of plastics of anterior abdominal wall defect with free umbilical cord autograft in newborns with gastroschisis. Patent for the invention No.124601, 13.10.2021, Bü. No.41.
Till H et al. (2003). Intrauterine repair of gastroschisis in fetal rabbits. Fetal Diagn Ther. 18(5): 297-300. https://doi.org/10.1159/000071969; PMid:12913337
Vanover M et al. (2017). Potential clinical applications of placental stem cells for use in fetal therapy of birth defects. Placenta. 59: 107-112. https://doi.org/10.1016/j.placenta.2017.05.010; PMid:28651900
Vanover M et al. (2019). High Density Placental Mesenchymal Stromal Cells Provide Neuronal Preservation and Improve Motor Function Following In Utero Treatment of Ovine Myelomeningocele. J Pediatr Surg. 54(1): 75-79. https://doi.org/10.1016/j.jpedsurg.2018.10.032; PMid:30529115 PMCid:PMC6339576
Velarde F et al. (2020). Use of Human Umbilical Cord and Its Byproducts in Tissue Regeneration. Front Bioeng Biotechnol. 8: 117. https://doi.org/10.3389/fbioe.2020.00117; PMid:32211387 PMCid:PMC7075856
Werbeck R, Koltai J. (2011, Oct). Umbilical cord as temporary coverage in gastroschisis. Eur J Pediatr Surg. 21(5): 292-295. https://doi.org/10.1055/s-0031-1277222; PMid:21678237
Yu J et al. (2003). Effects of prenatal dexamethasone on the intestine of rats with gastrosсhisis. J Pediatr Surg. 38(7): 1032-1035. https://doi.org/10.1016/S0022-3468(03)00185-4; PMid:12861532
Zakrzewski W, Dobrzyński M, Szymonowicz M et al. (2019). Stem cells: past, present, and future. Stem Cell Res Ther. 10: 68. https://doi.org/10.1186/s13287-019-1165-5; PMid:30808416 PMCid:PMC6390367
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Ukrainian Journal of Perinatology and Pediatrics
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal “Ukrainian Journal of Perinatology and Pediatrics” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license(СС BY-NC).
Authors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.
