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

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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)
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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-b2 attenuates macrophage
inflammatory responses in the developing
intestine
In collaboration with Akhil Maheshwari,
University of Alabama-Birmingham
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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
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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
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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