Research Training Fellowship: Dr S Khanjani
First published on 3 June 2009
Updated on 21 July 2014
What did the project achieve?
“My research has improved understanding of the behaviour of two proteins that play an important role in triggering the onset of labour,” says Dr Shirin Khanjani of Imperial College London. “I have revealed how these two proteins interact with each other – how they bind together and perform different roles.”
Improving understanding of what controls the timing of labour is important if we are to find ways to stop babies from being born prematurely.
Over 60,000 babies are born too soon every year in the UK.1-3 Tragically, premature birth is the biggest killer of babies in the UK, with around 1,300 babies dying each year after being born too soon.4-6 Many others who survive a very early birth develop lifelong disabilities such as cerebral palsy, blindness and learning difficulties.
Lots of premature births happen when women go into labour too soon – often for no apparent reason. “Throughout pregnancy, the womb remains relatively relaxed, but during childbirth it becomes capable of forceful contractions,” explains Dr Khanjani. “My work focuses on learning more about the factors that control the onset of labour and finding ways to stop it from happening too soon, so we can stop babies from being born early.”
This research was completed on 1 September 2012
What controls the onset of labour?
Each year, Action Medical Research awards these prestigious grants to help the brightest and best doctors and scientists develop their career in medical research. Dr Khanjani’s grant of £86,694 will fund her 18-month study into the molecules that trigger premature labour, with the longer-term aim of finding a way to prevent it.
Premature birth is the biggest killer of babies in the UK.1-3,a,b Sadly, around 1,500 babies die here each year after being born too soon.1-3,a,b Many others who survive a very early birth develop lifelong problems such as cerebral palsy, blindness and learning difficulties.
Despite these dangers, little is known about why some women go into labour too soon. Talented Dr Shirin Khanjani is determined to help fill this dire information gap. She hopes her studies of the protein interactions that might trigger labour could lead to ways to prevent premature birth.
She said: "It is an honour to receive this Fellowship and, at the same time, I feel a great deal of responsibility to try my hardest to make a difference in the search for ways to tackle preterm labour."
Born too soon
An estimated 50,000 babies are born prematurely each year in the UK.4,5,c Sadly, more than 25 of these babies die each week because of complications that arise from their early birth.1-3,a,b
Many premature births result from the mother going into labour too soon. ‘Premature labour – when a woman goes into labour more than three weeks early – is a major cause of death and disability, but at present there is little that can be done to stop it,’ says Dr Khanjani.
‘It is early preterm delivery, before 32 weeks of pregnancy, which is of greatest importance,’ says Dr Khanjani. ‘Early preterm birth is associated with a high risk of cerebral palsy and developmental delay, and with neuropsychological, educational, behavioural and social problems.’
The parents, siblings and other close relatives of premature babies can be profoundly affected by the stress of caring for them – in both the short and long term – and the economic costs are staggering.
Yet it is far from clear why so many women go into labour too soon. The causes and potential risk factors are not well understood. Much more research is needed if we are to tackle this common, serious and costly problem.
What triggers the onset of labour?
Dr Khanjani aims to improve understanding of the molecular processes that trigger labour.
Earlier research has already revealed important information about some of the molecules that are involved in labour once it has started. However, less is known about the factors that trigger labour in the first place. It is not clear what controls the timing of when a pregnant woman goes into labour – whether it occurs prematurely or at full term, when the baby is due.
Evidence suggests a protein called NF-kappaB plays a central role in triggering labour. This protein is a ‘transcription factor’, which means it binds to DNA and controls the production of other proteins.
‘I have discovered that the physical joining together of NF-kappaB with another protein, and with a hormone receptor, is important in controlling labour,’ explains Dr Khanjani. ‘In this study I will find out exactly how they bind together. This may enable us to find drugs that can change the way the proteins bind together and so control when labour starts.’
Dr Khanjani is using a state-of-the-art technique called combinatorial domain hunting to find out how the three-dimensional structures of the proteins affect the way they bind together.
|Project Leader||Dr S Khanjani MRCOG MD|
|Location||The Institute of Reproductive and Developmental Biology, Imperial College London and the School of Crystallography, Institute of Structural Molecular Biology, Birkbeck College|
|Grant awarded||3 March 2009|
|Start date||1 April 2009|
|End date||1 September 2012|
|Grant code||RTF1354, GN1743|
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Working towards a way to prevent premature birth
Dr Khanjani hopes to find out more about the molecular interactions that trigger labour. The information she reveals could ultimately lead to the development of new ways to prevent, or delay, premature labour and stop babies from being born too soon.
‘Identifying ways to stop women from going into labour prematurely could bring many benefits,’ explains Dr Khanjani. ‘It could cut costs to society by, for example, reducing both the number of babies who need intensive care at birth and the number who go on to need lifelong help. The potential benefits to babies and their families, of avoiding death and serious disabilities such as cerebral palsy, are too numerous to mention here.'
Into the future
Dr Khanjani’s important research is being supervised by experienced clinicians and scientists who are world leaders in their fields. They are ensuring that this talented, committed and highly intelligent young researcher gains expertise in cutting-edge techniques so she can pursue her dream of leading the research of the future. ‘It is very hard to describe the psychological rewards of my work in words’, explains Dr Khanjani. ‘Quite simply, it feels wonderful to make any contribution towards other people’s health.’
- Office for National Statistics. Health Statistics Quarterly 28 (Winter 2005), 32 (Winter 2006), 36 (Winter 2007)
- General Register Office for Scotland,Vital Events Reference Tables 2006
- Northern Ireland Statistics and Research Agency. Registrar General Annual Report 2006
- Office for National Statistics. Health Statistics Quarterly 35 (Autumn 2007),Table 2.1
The Information Centre, Community Health Statistics. NHS Maternity Statistics, England: 2003-04, 2004-05, 2005-06
a. For England and Wales, deaths listed as due to “immaturity related conditions”
b. For Scotland and Northern Ireland, deaths listed as due to “disorders related to length of gestation and fetal growth”
c. Calculation made by Action Medical Research based on figures in references 1 and 2 for the number of births a year in the UK and
the number of preterm deliveries in England, respectively. Estimate assumes incidence of premature birth is the same for the UK overall
as it is for England