Abstract
Iatrogenic preterm prelabour rupture of fetal membranes (iPPROM) occurs in 6-45% of the cases after fetoscopic procedures posing a significant threat to fetal survival and well-being. Number of available diagnostic and therapeutic fetal interventions is increasing and thus developing treatment options for iPPROM is growing more important than ever before. Fetal membranes exhibit very restricted regeneration and little is known about factors which might modulate their healing potential, rendering various materials and strategies to seal or heal fetal membranes pursued over the past decades relatively fruitless. Additionally, biocompatible materials with tunable in vivo stability and mechanical and biological properties have not been available. Using poly(ethylene glycol) (PEG)-based biomimetic matrices we provide evidence that upon presentation of appropriate biological cues in 3D, mesenchymal progenitor cells from amnion can be mobilized, induced to proliferate and supported in maintaining their native extracellular matrix production, thus creating a suitable environment for healing to take place. These data suggest that engineering materials with defined mechanical and biochemical properties and the ability to present migration and proliferation inducing factors, such as PDGF, bFGF, or EGF could be key in resolving the clinical problem of iPPROM and allowing the field of fetal surgery to move forward.
Kivelio, A