Tiny organs grown from amniotic fluid could spot problems before birth

tiny organs grown from amniotic fluid could spot problems before birth

New technique does not actually touch the baby so there are no restrictions on how late it can be carried out

Tiny organs have been grown from the amniotic fluid of unborn babies in a major breakthrough that could help spot problems before birth.

A team at University College London (UCL) and Great Ormond Street Hospital showed that fluid flowing around the baby in the womb contains foetal stem cells, which can be extracted and grown into 3D mini-kidneys, lungs and stomach.

By testing how well the organs are functioning, experts can determine whether a baby is healthy, or in trouble, and it marks the first time that human development has been observed so late in pregnancy.

The researchers are hopeful it could pick up dangerous conditions such a congenital diaphragmatic hernia (CDH), where the lungs are crushed by the internal organs, cystic fibrosis, or oesophageal atresia, where the oesophagus does not connect to the stomach.

“We know so little about late human pregnancy, so it’s incredibly exciting to open up new areas of prenatal medicine,” said Dr Mattia Gerli, first author of the study from UCL’s surgery and interventional science department.

Currently, ultrasound scans do not take place after 21 weeks, and there is a ban on taking samples of a foetus 22 weeks after conception, which means the final few months of a baby’s development have been a black box until now.

Crucially, the new technique does not actually touch the baby, only the amniotic fluid, so there are no restrictions on how late it can be carried out during pregnancy.

Amniotic fluid is a bubble of liquid that surrounds the foetus acting as a cushion as it develops.

In early pregnancy it is made of water produced by the mother, but by 20 weeks it largely consists of waste fluids from the foetus, meaning it is a treasure trove of biological information about how the kidneys and intestines are performing.

The baby also breathes the amniotic fluid in and out, helping to prime the lungs, so it also contains stem cells from the lungs.

Genetic testing

In the study, 12 women had stem cells extracted from the amniotic fluid between 16 and 34 weeks of pregnancy. The team then used genetic testing to separate the cells into those from the lungs, kidneys or the gastrointestinal tract.

After being cultured in the lab, by around four weeks, the cells had assembled into tiny lentil-sized organs which could be studied.

To test the technique, the scientists then compared mini-lungs from babies with CDH to those from healthy foetuses.

They found important differences between the healthy mini-lungs and those from CDH infants, suggesting they could be used to diagnose the condition.

CDH can be treated temporarily by inserting a saline-filled balloon into the airway to protect the lungs from being crushed until the diaphragm can be repaired after birth.

The team also grew mini-organs from babies who had undergone the balloon treatment and found they functioned far better, showing that the treatment was working.

Used to test drugs and therapies

The researchers are hopeful that the tiny organs could be used to test drugs and therapies before they are used, to see if they will be effective.

Prof Paolo de Coppi, senior author of the study from UCL Institute of Child Health and Great Ormond Street Hospital, said: “This is the first time that we’ve been able to make a functional assessment of a child’s congenital condition before birth, which is a huge step forward for prenatal medicine.

“Diagnosis is normally based on imaging such as ultrasound or MRI and genetic analyses.

“When we meet families with a prenatal diagnosis, we’re often unable to tell them much about the outcome because each case is different.

“We’re not claiming that we can do that just yet, but the ability to study functional prenatal organoids is the first step towards being able to offer a more detailed prognosis and, hopefully, provide more effective treatments in future.”

Commenting on the research, which was published in Nature Medicine, Roger Sturmey, professor of reproductive medicine at the University of Hull, said: “This research paves the way for scientists to study how key organs are formed and perform their function in the developing foetus during pregnancy, without the need for tissue extracted directly from a foetus.”

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