Foetal membranes can repair themselves after injury

An international research team has shown that foetal membranes are able to heal after injury, as per a study published in the journal Scientific Reports.

The integrity of the foetal membranes that surround the baby in the womb during pregnancy is vital for normal development. But foetal membranes can become damaged as a result of infection, bleeding, foetal surgery and even diagnostic tests during pregnancy — such as amniocentesis, which requires doctors to make a hole with a needle in the foetal membrane sac. Currently there are no clinical approaches available to repair or improve healing in the foetal membranes, and until now it was unclear if small holes in the membranes were able to heal themselves.

Led by scientists from the Queen Mary University of London, the research team created small defects using a needle in donated human foetal membrane tissue, to mimic damage caused during foetal surgery. A few days after injury, the researchers discovered a population of cells called myofibroblasts (MFs), which play an important role in wound healing, and found that these cells crawled towards the edges of the wound and into the defect site. This cell population produced collagen and started to pull the edges of the wound, contracting the tissues together and repairing the wound.

The findings follow on from the team’s previous work that highlighted the importance of a protein called Connexin 43 (Cx43) in the process of wound healing and repair. In this study, the researchers show that Cx43 was expressed by two cell populations — amniotic mesenchymal cells (AMCs) and MFs — and that the localisation and levels of Cx43 measured were different. They also found that overexpression of this protein affected the ability of cells to migrate into the defect site and close the wound.

“We have always thought that small-diameter wounds created in human foetal membranes rarely heal by themselves, but here we show that the tissues have the potential to do this,” said Dr Tina Chowdhury, Senior Lecturer in Regenerative Medicine at Queen Mary. “We found that Cx43 has different effects on cell populations found in the membranes and promotes transformation of AMCs into MFs, triggering them to move, repair and heal defects in the foetal membranes.”

The premature rupture of foetal membranes, known as preterm pre-labour rupture of membranes (PPROM), is a major cause of preterm birth accounting for around 40% of early infant death. Therefore, the successful repair of foetal membranes could help reduce the risk of birth complications.

“Finding that the foetal membranes have this potential to heal is a huge step towards developing treatments for women with PPROM,” said study co-author Professor Anna David, from University College London. “It holds out hope that we may be able to delay or even prevent preterm birth, which will significantly improve baby outcomes.”

Image caption: Wound healing in foetal membrane tissue. Images show the protein collagen (left) and cells (right).

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