In addition to reconstructing the genomic alterations that the cells undergo to generate this leukemia, the study has also identified a molecular mechanism that had not been observed before in this type of leukemia and which causes the activation of a gene, called MNX1, which is frequently altered in this type of tumor.
Knowledge of these alterations is essential for developing cell and animal models that allow us to understand the disease’s evolution and develop new therapies for treating these pathologies.
Navels, belly buttons, innies or outies … whatever term you use, your umbilicus may have plenty to tell you about the state of your health.
For some, they are the thing of nightmares—omphalophobia (the fear of belly buttons) is a real condition. For others, they are a fashion accessory to be shown off in a crop top, or decorated with a body piercing.
PLACENTA ABRUPTION
The placenta is a crucial structure that develops in pregnancy and attaches to the uterine wall, connecting with the umbilical cord to help nourish the fetus.
In about 1 in 100 pregnancies, the placenta separates prematurely from the womb, after about 20 weeks of pregnancy. That can pose a life-threatening risk to the fetus and can cause dangerous maternal bleeding.
While blood from a newborn’s umbilical cord was once considered a waste product, it’s now known that it contains stem cells. These cells can be used for cord blood transplants, including for specific genetic and hematologic conditions, and some cancers—potentially saving lives.
“Cord blood is the blood that remains in the umbilical cord after birth. It contains red blood cells that can carry oxygen, nutrients and stem cells. Stem cells replenish cells in blood, skin and organs,” says Dennis Costakos M.D., a neonatologist at Mayo Clinic Health System in La Crosse. “When your baby is born, delaying cord clamping for 30–60 seconds benefits your baby. Delaying cord clamping for this time frame allows for higher distribution of blood to your infant rather than leaving this precious blood in the placenta. Delaying cord clamping for 30–60 seconds for babies born prematurely decreases the serious complications of prematurity that can be life-threatening. Full-term babies are less likely to be iron-deficient at 3–6 months of age, which is important for health and development.”
The other important note is how cord blood can affect the lives of others.
“Cord blood is one of the three sources of blood-forming cells used in transplants. Bone marrow and peripheral blood stem cells are the other two sources of cells,” Dr. Costakos describes. “Cord blood contains stem cells that can be used to treat certain diseases. Current uses for cord blood transplant include certain genetic and hematologic conditions, and some cancers.”
If a sibling or family member has one of these conditions, the health care team can provide input on whether a donation to a private or public cord blood bank could be considered. Public cord blood banks are a viable option for helping others in need.
BCNatal, a consortium formed by Hospital Sant Joan de Déu and Hospital Clínic, is one of the pioneering centres in clinical research in fetal surgery, has developed and performed for the first time in the world a number of current techniques, it receives physicians from all continents for specialized training and performs more than 100 fetal surgeries a year on national and international patients having conducted a total of 2,000 operations of this type.
In the first large-scale clinical study to characterize stem cells from the umbilical cord blood and tissues of premature infants with bronchopulmonary dysplasia—a severe, chronic lung disease—researchers found that these babies had more stem cells at birth. They also found that a growth factor (G-CSF), which is responsible for stem cell migration and differentiation, is decreased in these infants. Based on these results, researchers speculate that the increase in cord stem cells might play an early role in the development of bronchopulmonary dysplasia, which is usually diagnosed when the infant is 2-3 months old. Their findings, published in the Frontiers in Pediatrics, also add to the identification of disease risk factors, as well as contribute to the research into cell-based therapies for prevention and management of bronchopulmonary dysplasia.
“We want to be able to use stem cell therapies to regenerate the damaged and underdeveloped lungs of premature infants with bronchopulmonary dysplasia,” says senior author Karen Mestan, MD, MSCI, neonatologist at Ann & Robert H. Lurie Children’s Hospital of Chicago and Associate Professor of Pediatrics at Northwestern University Feinberg School of Medicine. “Our characterization of cord stem cells in these infants is a big step toward development of stem cell therapies to manage and possibly prevent this challenging disease.”
About 10,000 babies a year develop bronchopulmonary dysplasia. Premature infants, and especially those born more than 10 weeks preterm and weigh less than two pounds, are at highest risk. However, there are no clear predictors of this disease.
To study the stem cell differences between premature infants who develop bronchopulmonary dysplasia and those who do not, Dr. Mestan and colleagues collected cord blood and tissue from 200 preemies of different gestational ages. They measured the percentage of hematopoietic stem cells (those circulating in blood) and mesenchymal stem cells (those derived from umbilical cord tissue). They also evaluated biochemical factors in cord blood plasma.
“We need more research to understand why premature infants who later are diagnosed with bronchopulmonary dysplasia are born with more hematopoietic and mesenchymal stem cells,” says Dr. Mestan. “Their stem cells might not be functioning properly, or maybe they are not mobilized effectively to differentiate into healthy blood or tissue cells.”
Clinically, the increase in cord stem cells, if validated by more studies, might be one of the risk factors for bronchopulmonary dysplasia.
“As we get better at predicting this disease and have more tools to intervene, we’ll be able to individualize management of preemies and deliver the right treatment at the right time to improve outcomes,” says Dr. Mestan.
Exposure to acetaminophen in the womb may increase a child’s risk for attention deficit/hyperactivity disorder and autism spectrum disorder, suggests a study funded by the National Institutes of Health and the Agency for Health Care Research and Quality. The study was conducted by Xiaobing Wang, M.D., of the Johns Hopkins University Bloomberg School of Public Health, Baltimore, and colleagues. It appears in JAMA Psychiatry.