“Our study is the first to look at such a large sample size and examine the entire epigenome, so it’s not just looking at the stress control genes as in previous studies, it’s looking at all the epigenomic sites available right now that you can study,” she says.
The research examines five separate categories of stress that expectant moms face during pregnancy. They are financial stress, conflict with a partner, conflict with a family member or friend, abuse (including physical, emotional and mental) and death of a friend or relative, plus a cumulative score that combines all the categories.
“We found that when mom experienced a cumulative amount of stress during pregnancy, there was, in fact, an association with DNA methylation in umbilical cord blood, which is a kind of epigenetic modification in the baby that’s developing in the womb,” Ruehlmann says.
“An epigenetic modification is something that doesn’t change the sequence of the DNA, however the DNA is modified which is something that’s dynamic and can change in response to environmental exposures. Therefore, it’s something that can be turned on or off later in the child’s life or something that can maybe not do anything, it’s still unknown. It’s thought to be a mechanism of gene expression control.”
Here are the main points about how cord blood is transforming pediatric care:
- 1. Stem Cell Therapies
- 2. Regenerative Medicine
- 3. Personalized Medicine
- 4. Ease of Access and Use
- 5. Innovations in Treatment
- 6. Long-Term Health Benefits
“In COVID-19, thrombosis is a major cause of death. So, our findings tell us that we should focus on understanding more about NETs’ role in clotting in COVID-19,” Mikala Egeblad, Ph.D., a cancer researcher from Cold Spring Harbor Laboratory, says. “Thrombosis is also a major cause of death in late stage cancer, where there also can be elevated NETs in the blood. Therefore, I think that what we learn from COVID-19 will help us with other diseases, including cancer.”
Additionally, laboratory experiments showed that a small protein found in umbilical cord blood of newborn babies, called neonatal NET Inhibitory Factor (nNIF), quiets the hyperactive NET response in white blood cells treated with COVID-19 patient plasma. This peptide is thought to protect babies from harmful inflammation early in life, explains Schiffman, CEO of PEEL Therapeutics. His company is now evaluating whether the protein could become the basis for a clinical treatment.
“Newborns babies have a natural therapeutic in their blood to protect against these same inflammatory events that we think could be killing COVID-19 patients,” Schiffman says. “This targeted approach to stopping NETs may be more effective with less side effects than some other drugs being tested now in COVID-19 patients that block the entire immune system¬¬¬¬.”
When a cancer patient needs a bone marrow transplant, there are four common donor sources: A matched related donor (sibling), a matched unrelated donor (from a donor database), a half-matched donor, or umbilical cord blood. Of course, there are plusses and minuses to each approach, but consensus has generally ranked a matched sibling first, followed by a matched unrelated donor, with cord blood and half-matched donors reserved for patients without either of the first two options. Now a University of Colorado Cancer Center study based on a decade of research and treatment may reshuffle this list. In fact, the comparison of 190 patients receiving cord-blood transplants with 123 patients receiving transplants from the “gold standard” of matched sibling donors showed no difference in survival outcomes between these two approaches, with significantly fewer complications due to chronic graft-versus-host disease in patients receiving transplants from cord blood.
“Our cord blood patients were doing as well as patients receiving transplants from matched siblings, and in selected populations cord blood patients were doing even better. Our program at CU Cancer Center is somewhat unique in its emphasis on cord blood as a donor source for stem cell transplants and this study is an affirmation of why we do what we do here,” says Jonathan Gutman, MD, CU Cancer Center investigator and director of the allogeneic stem cell transplantation program at UCHealth University of Colorado Hospital.
“I felt like we had a superhero come in on this jet plane, and he had this box of super cells,” Heath Sexton says with a big smile stretching across his face. “And it felt like you’d come to save my son.”
A few hours later, Dr. Nelson and his team from Mayo Clinic were back on board Mayo Clinic’s fixed-wing plane to head back to Minnesota and begin preparations for the next cell delivery in the clinical trial.
In an effort to expand the research and help more families, in 2017 the HLHS team at Mayo began creating a hypoplastic left heart syndrome research consortium.
“So we’ve built this infrastructure to be able to do clinical trials, and ultimately, we need to be able to have a large number of families participating in that,” Dr. Nelson says. “So the consortium really represents our ability to take the science and technology and teams of people to other centers of excellence that allows us to interact with more families at more locations.”
CHOP joined Mayo Clinic as the first members of the consortium, and Ryals was the first patient to benefit from it.
Within a few months, Children’s Hospital of Los Angelesbecame the third institution to join the consortium, followed soon after by Children’s Minnesota.
Dr. Nelson sees the collaboration eventually leading to breakthroughs that once seemed impossible.
“You can even imagine where the technology is leading us—to be able to recreate patches and constructs and maybe even whole ventricles that can be engineered, that can be transplanted at some point,” he says.
The days after Ryals received his cells were filled with firsts for the Sextons: a first smile and a first bottle.
They were able to bring Ryals back home to Alabama as a growing, relatively healthy baby boy.
And they finally have what they feared they never would: a sense of normalcy and a chance to dream about Ryals’ future.
“I guess I see the survivors of the day that are having children and having careers,” Heath Sexton says. “And that’s what I see my son as. And the hope is that he can see his grandchildren.”
“I see college,” Andrea Sexton says. “I see happiness and I see my boys playing together. I see a happy family. And I believe that this work, this research that these doctors have put hard work into is going to—to let us achieve that.”
Ryals continues to need minor procedures to maintain the health of his heart. But now, instead of fear and worry filling the Sextons’ home, a baby’s laughter does.