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Evaluating the role of photobiomodulation in human cervical remodeling in pregnancy

评估光生物调节在人类妊娠期宫颈重塑中的作用

基本信息

批准号：
10470290
负责人：
Christine P Hendon
金额：
$ 20.25万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2024-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10470290
关键词：
3-Dimensional Affect Area Attenuated Bathing Biological Assay Bluetooth Cervical Cervical Ripening Cervix Uteri Cesarean section Clinical Collagen Data Deposition Device or Instrument Development Devices Discipline of obstetrics Electrical Engineering Engineering Etiology Exhibits Extracellular Matrix Failure Fetus Future Gel Goals Healthcare Human Inflammation Inflammatory Interstitial Collagenase Intervention Knowledge Light Matrix Metalloproteinases Mechanics Mediating Mothers Muscle relaxation phase Opsin Organ Pathway interactions Perfusion Perinatal mortality demographics Pessaries Phototherapy Play Pregnancy Pregnancy Rate Premature Birth Premature Infant Process Production Protocols documentation Relaxation Reporting Research Research Personnel Risk Role Smooth Muscle Smooth Muscle Myocytes Sphincter Tensile Strength Testing Therapeutic Intervention Time Tissue Sample Tissues Translations Uterus Vaginal delivery procedure Validation Vascular Smooth Muscle Woman cervical remodeling chemokine clinical care comorbidity cytokine disability emerging adult experimental study exposed human population healing in vivo mechanical properties mortality mortality risk multidisciplinary multiplex assay neonatal death nonhuman primate novel novel strategies novel therapeutics perinatal morbidity photobiomodulation pregnant premature prevent receptor soft tissue wireless wound healing

项目摘要

ABSTRACT: In order for a fetus to deliver at term, the cervix must remodel, soften and dilate at the appropriate time in pregnancy. If the cervix remodels prematurely, the pregnancy is at risk for spontaneous preterm birth (sPTB), an obstetric dilemma that affects 1 in 10 pregnancies in the U.S. each year and places babies at increased risk for neonatal death, lifelong comorbidities and/or mortality in early adulthood. Conversely, if the cervix exhibits deficient or delayed cervical remodeling and dilation, the pregnancy may go past the due date which increases the risk for perinatal morbidity/mortality and risks to the mother, including a doubling in the cesarean delivery rate. To date, therapeutic interventions to prevent premature cervical remodeling leading to sPTB or inadequate cervical remodeling leading to post-term pregnancies are limited and not entirely effective. Photobiomodulation (PBM) using low level light therapy (LLLT) is currently being used in clinical settings such as wound healing as PBM with blue light has been shown to induce vascular smooth muscle relaxation (increasing tissue perfusion) and red/infrared light can modulate inflammation, ECM remodeling and mechanical strength of healing tissues. To date, we have demonstrated that the internal os of the human cervix contains a significant amount of contractile smooth muscle (that likely forms a sphincter which keeps the cervix closed during pregnancy) and human cervical smooth muscle cells play a role in cervical ECM remodeling by secreting proinflammatory cytokines and matrix metalloproteinases (MMPs). Given that PBM can modulate smooth muscle contractility, inflammation/ECM remodeling and tissue strength, in this proposal, we aim to determine if we can harness the power of light and use LLLT to enhance or attenuate cervical smooth muscle mediated contractility, proinflammatory/ECM remodeling pathways and cervical tissue mechanical properties. In addition, since our team of multidisciplinary investigators includes world class engineers with expertise in human soft tissue mechanics and electrical engineering, our goal is to develop a novel, wireless intravaginal LLLT device (for subsequent validation non-human primates) that can emit specific wavelengths of light for controlled time periods. The knowledge obtained from the proposed studies hold great promise for translation to clinical care as novel treatments to prevent or reverse premature cervical remodeling leading to sPTB or to augment cervical remodeling/dilation in women at term.

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