Congenital Diaphragmatic Hernia as a Potential Target for Transamniotic Stem Cell Therapy.
We sought to determine whether TRASCET could impact congenital diaphragmatic hernia (CDH).
Twelve pregnant dams received Nitrofen on gestational day 9.5 (E9; term = 22 days) to induce fetal CDH. Fetuses were divided into three groups: untreated (n = 31) and two groups receiving volume-matched intraamniotic injections of either saline (n = 37) or a suspension of 2 × 106 cells/mL of amniotic fluid-derived mesenchymal stem cells (afMSCs; n = 65) on E17. Animals were euthanized at term. Expression of fibroblast growth factor-10 (FGF-10), vascular endothelial growth factor-A (VEGF-A), and surfactant protein-C (SPC) was quantified by qRT-PCR. Statistical analysis was by the Mann-Whitney U test with Bonferroni adjusted criterion (p ≤ 0.01).
Among survivors with CDH (n = 27/133), the TRASCET group showed significant downregulation of FGF-10 and VEGF-A gene expressions compared to the untreated (p < 0.001 for both) and saline groups (p = 0.005 and p = 0.004, respectively). SPC expression was higher in the TRASCET group compared to the untreated group (p = 0.01), but not the saline group (p = 0.043). Lung laterality had minimal impact on these comparisons.
Transamniotic stem cell therapy affects select processes of lung development in experimental congenital diaphragmatic hernia. Further scrutiny into this novel therapy as a potential component of the prenatal management of this disease is warranted.
LEVEL OF EVIDENCE:
N/A (animal and laboratory study).
Copyright © 2019 Elsevier Inc. All rights reserved.
Amniotic mesenchymal stem cells; Congenital diaphragmatic hernia; Fetal stem cells; Fetal therapy; TRASCET; Transamniotic stem cell therapyPMID: 31753611 DOI: 10.1016/j.jpedsurg.2019.10.033