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Growth factors to restore foetal lung growth

The insufficient development of lungs, a condition known as pulmonary hypoplasia, accounts for nearly 15 % of perinatal deaths. European researchers tested the effect of various growth factor interventions in the perinatal period to induce lung growth and improve foetal survival.
Growth factors to restore foetal lung growth
Pulmonary hypoplasia is the result of a number of developmental defects that in essence lead to respiratory deficiency and pulmonary hypertension in the neonatal period. A number of prenatal interventions have been suggested to induce foetal lung growth, including endoscopic tracheal occlusion to close the open trachea. This method, however, is invasive and runs the risk of premature rupture of respiratory membranes.

Pharmacological agents have also been explored, but mainly at the experimental level. On a similar note, the EU-funded 'Impact of surgical and pharmacological interventions on fetal lung growth in pulmonary hypoplasia' (INCREASELUNGGROWTH08) aimed to explore non-surgical treatment options — mainly in the form of growth factors — in order to accelerate foetal lung development and proliferation.

Researchers administered insulin growth factor 1 (IGF-1) in the amniotic sac in pregnant rats. Although IGF-1 seemed to improve lung maturation and vasculogenesis, the effect was gender specific and only proved beneficial in male foetuses.

Scientists also explored IGF-2 treatment in the same pre-clinical model to find that it had a proliferative and angiogenic impact on lung tissue and could promote branching of airway structures. Although the proposed therapeutic approaches are promising with respect to improving postnatal survival and lung function, further investigation to test adverse effects is required.

From a clinical perspective, any animal studies should be translatable into future clinical applications. Therefore, the clinical part of the INCREASELUNGGROWTH08 work entailed the evaluation of babies using foetal organ scans by two-dimensional (2D) and three-dimensional (3D) ultrasound or foetal magnetic resonance imaging (MRI).

Stratification of affected babies into different prognostic groups would allow clinicians to propose appropriate therapy based on disease severity. Coupled with minimally invasive treatment modalities in the form of growth factors, this could increase the number of surviving babies.

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