By: 14 December 2017
Bioengineering could be a viable alternative to open feotal repair for spina bifida

Researchers from Children’s Hospital Colorado and the University of Colorado Anschutz Medical Campus recently discovered a promising alternative to open feotal surgery for spina bifida repair.

Ahmed Marwan, feotal surgeon and researcher at the hospital’s Colorado Fetal Care Center, along with researchers Deawon Park, and James Bardill from the CU Department of Bioengineering, have developed an alternative approach to current in utero treatment for spina bifida: a minimally-invasive repair using a bioengineered material – a reverse thermal gel (RTG) – to cover the neural tube defects (NTD) at an earlier gestational age than traditional treatment.

While developing in the mother’s womb, a baby’s brain and spinal cord form a neural tube. Failure of this tube to fully close causes NTDs, such as spina bifida. As many as 10 per cent of infants born with an open NTD die because of related complications, while nearly 1,500 babies are born with spina bifida each year.

The recently published research, led by Marwan and his team, studied the effects of the chemically synthesised, novel RTG called PSHU-PNIPAAm and characterised its ultrastructure by scanning electron microscopy, its stability in amniotic fluids and its permeability.

“Our team’s specific aim was to study the effects of the chemically synthesised material on the basic cellular functions of mouse neonatal fibroblasts, keratinocytes and neurons – the types of cells exposed in open NTDs, and inject the material into mouse embryos in utero,” said Marwan, who is also an assistant professor of surgery at the CU School of Medicine. “We found that the in utero application of the biomaterial was technically feasible and did not harm feotuses. The RTG successfully formed a gel and attached to the skin, demonstrating successful in utero suitability as a potential alternative for NTD closure.”

As studies continue, Marwan and his team will explore the ability of the RTG to act as a scaffold for cellular interaction, and they will make additional chemical modifications to incorporate biomolecules that mimic the extracellular matrix environment of a feotus and enhance cellular activities.

The potential to use the RTG in a minimally invasive approach at an earlier gestational age offers a promising alternative to current in utero repairs for spina bifida.

Source: Children’s Hospital Colorado

Reference: Ahmed I. Marwan, Sarah M. Williams, James R. Bardill, Jane Gralla, Noraishah M. Abdul-Aziz, Daewon Park. Reverse Thermal Gel for In Utero Coverage of Spina Bifida Defects: An Innovative Bioengineering Alternative to Open Fetal Repair. Macromolecular Bioscience, 2017; 17 (6): 1600473 DOI: 10.1002/mabi.201600473