The placenta may be the most important organ in a body – it gives life to us all – and yet it is probably the least-studied organ.
The placenta is the gatekeeper for a foetus, allowing a mother’s nutrients to pass in one direction while waste passes back into the mother’s bloodstream. It produces hormones to encourage foetal growth and offers protection against most bacteria, although not against viruses.
But, when the placenta fails to function normally, it can put the health and life of both foetus and mother at serious risk, leading to hundreds of thousands of deaths every year. Among the biggest such problems is pre-eclampsia, which kills half a million babies and around 76,000 mothers every year globally.
The condition affects up to 5 per cent of all pregnancies – Kim Kardashian recently suffered both pre-eclampsia and placenta accreta, another dangerous condition in which the placenta grows too deeply into the wall of the uterus.
Even when babies survive pre-eclampsia, they can suffer from growth restriction or other health problems, including brain and heart defects, and diabetes, later in life. Growth restriction is the most common factor in still-births, when there are insufficient placental blood vessels to keep the foetus nourished.
And how do we treat this killer condition? The tools we have are no more advanced than aspirin, and premature deliveries.
Aspirin is our frontline tool but is effective only if taken early in pregnancy. Other drugs combat symptoms, such as lowering blood pressure.
Ultimately, our only prevention is to induce premature delivery.
Research into the placenta is desperately needed, which is why my team at Aston Medical School is developing a radical new way of carrying out tests on the organ.
The Aston University team will collaborate with engineers from a Dutch company, Mimetas, developing a method of growing human placentas on a ‘chip’ – we call it iPlacenta. The placentas are grown from cells harvested from umbilical cords, and so treatments can be tested without any risk to either mothers or foetuses.
These chips, which are about the size of a mobile phone, will hold up to 48 miniature placentas, each one of which can be an individual experiment. The chips can be slotted into existing equipment to make analysis both relatively easy and inexpensive.
The tiny placentas can also mimic the organ’s diseased state, hopefully allowing us an insight into how pre-eclampsia develops, so the condition can ultimately be identified and treated early.
This new research may be groundbreaking – even growing a single placenta would be an achievement – but it’s only one of three approaches we are taking at Aston. We’re also working on ultrasound techniques, with Samsung and FUJIFILM VisualSonics, to better understand the placenta and help us identify those most at risk.
And we’re also teaming up with mathematicians at the University of Rostock in Germany to build a huge computer model to help us understand pre-eclampsia. Ultimately, our ambition is to be able to use this model to predict outcomes for individual patients, and to help us build experiments for our iPlacenta chips.
The Aston research I coordinate is backed by €4million funding from the EU’s Horizon 2020 research and innovation programme, and will involve experts in ten different centres feeding information into our programme. We are based at the UK’s newest medical school, at Aston University, which is headed up by Professor Asif Ahmed, a worldwide authority on pre-eclampsia.
Our research is really only just beginning and, as well as bringing health benefits, we hope that eventually our work will save the health service money – a lot of money.
It has been estimated that premature births cost the NHS almost £1billion a year, and that delaying premature births by just one week could save the NHS £260million a year – that’s because premature babies tend to need the highest levels of care.
But, as important as the financial costs are, it’s the human costs that are most significant. Kim Kardashian has been candid about the suffering pre-eclampsia and placenta accreta caused her, and she has access to the finest medical teams.
Tens of millions of other mothers around the world are not so lucky, which is why we need to be able to identify these conditions and treat them long before they become life-threatening and require major medical intervention.
This is, literally, a matter of life and death – for both mothers, and for babies who have barely started their lives.
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