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Reproductive
Biology
(Studentship: Ms.
Jennifer Winter - Mount Sinai Hospital)
Over
400,000 children are born annually in Canada, and an
estimated 40,000 of these births will be complicated
by intrauterine growth restriction and/or pre-eclampsia.
Such babies are at significantly increased risk of death
or serious illness. Because of the severe threat to
these fetuses in-utero, many of them will be electively
delivered preterm, adding prematurity to the medical
complications that they face. Reducing the incidence
of pre-eclampsia and preterm birth would have a tremendous
impact on health care delivery. The major hurdle in
developing therapies to prevent these complications
of pregnancy is that their underlying cause remains
an enigma. However, it is now generally accepted that
a common element in pre-eclamptic pregnancies is a failure
of normal placental development, in particular the failure
of trophoblast cells to adequately invade the maternal
uterine tissues so as to establish the optimal environment
for the developing fetus. Jennifer Winter's research
project builds upon a series of novel experiments in
which we have defined components of the TGFB system
that play a major role in regulating trophoblast differentation
and invasion. She is currently investigating the role
of oxygen in regulating TGFB functions. Moreover, very
recently we have gained preliminary data to suggest
that expression of this system may be disrupted in pre-eclamptic
pregnancies and may therefore contribute to the underlying
genesis of the disease.
Maternal-Fetal
Medicine
(Studentship: Ms.
Natty Nashman - Mount Sinai Hospital)
Preterm
labour and delivery occurs in 5-10% of all pregnancies,
but accounts for over 85% of all death and disability
amongst newborn babies. Currently there is no treatment
that can prevent preterm labour. In recent years there
has actually been an increase in the incidence of preterm
birth, due largely to an increase in the number of twin
and higher order multiple pregnancies. The increased
rate of preterm birth in multiple pregnancies is likely
due to the increased stretch (tension) on the myometrium
as a result of the increased intrauterine volume. Normally
as the fetus grows the uterus also grows, to reduce
the tension in the myometrium that would otherwise lead
to the onset of labour. We hypothesize that in multiple
pregnancies uterine growth cannot keep pace with fetal
growth. Ms. Nashman will study the mechanisms that regulate
uterine growth during pregnancy. In particular, she
will investigate the mechanisms by which uterine stretch
is recognized by myometrial cells and translated into
molecular signals that regulate cell division and cell
growth. Since pregnancy hormones also regulate uterine
growth Ms. Nashman will investigate the interactions
between mechanical and hormonal signals in the regulation
of uterine growth. These studies will provide increased
knowledge of the mechanisms that control the growth
of the uterus during pregnancy and may reveal targets
for new drug therapy to prevent preterm labour, particularly
in multi-fetal pregnancies.
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