Key step forward in search for treatment to prevent premature labour
Researchers funded by children’s charity Action Medical Research, have made an important step forward in the search for a novel treatment to help prevent premature birth.
About 60,000 babies are born prematurely each year in the UK[i] and those born very early are at risk of dying, or developing serious disabilities.
The research team from the Institute of Cell Signalling at the University of Nottingham focused on finding a way of stopping contractions when labour starts too early. They are confident the progress they have made could potentially lead to a drug treatment which could stop these early contractions, giving premature babies that vital extra time to continue to develop in the womb, which can make the difference between life and death.
The research was led by Dr Joanne Lymn, Associate Professor and Deputy Director of Research in the School of Nursing, Midwifery and Physiotherapy, working with Dr Raheela Khan and Professor Stephen Hill. Their first set of results have just been published inBiology of Reproduction[ii].
Currently, if a woman goes into early labour, licensed tocolytic drugs (used to delay birth) can only be used for up to 72 hours. This allows enough time for mother and baby to be transferred to a specialist unit but does not significantly improve the outcome for the baby. New treatments are therefore urgently needed.
In this project, the researchers studied smooth muscle tissue, taken with consent from women who underwent caesarean sections. Some of these women were in labour and some were not. They also took samples from women who weren’t pregnant but were undergoing a hysterectomy.
The researchers showed that specific enzymes called transglutaminases seem to have a key role in the signalling pathways that control the contraction of smooth muscle in the wall of the womb during labour.
The researchers found that certain compounds which inhibit tissue transglutaminase 2 can significantly reduce contractions in laboratory tissue samples taken from pregnant women. This means it could now become a potential target for creating a drug therapy to help stop early contractions.
Dr Lymn said: “An additional gestational week can be significant in reducing incidence or severity of disease. Our recent data has demonstrated that inhibitors to the enzyme tissue transglutaminase can significantly reduce contractions in tissue samples at term.
“While more research is needed to determine the exact role of tissue transglutaminase in regulating contractions this enzyme has also been revealed to be a potential drug target in a number of other disease states and so the development of effective drug therapy to change the activity of this enzyme is beginning to gather pace. This could lead to the development of effective drug therapy within 5-10 years,” she added.
Alexandra Dedman, Senior Research Evaluation Manager, for Action Medical Research, said: “This is very exciting news and we are delighted to have been able to fund this vital research. If a drug therapy could be developed to help delay some cases of premature labour it could potentially make the difference between a premature baby surviving or not.”
In a study of babies born before 26 weeks of gestation in the UK and Ireland in 1995 (the EPICure 1 study), the survival of babies born at 22 weeks was a very rare event, while 81% of those born at 24 weeks survived.[iii]
A follow up study EPICure 2, in 2006, showed that survival rates had increased for babies born at 24 and 25 weeks of gestation since 1995. However, the study did not show any significant improvement in the survival rate for premature babies under 23 weeks over the past 10 years. [iv]
NOTES TO EDITORS:
For further information please contact: Claudine Powell, Communications Manager
Action Medical Researchis the leading UK-wide medical research charity dedicated to helping babies and children. We know that medical research can save and change children’s lives. For nearly 60 years we have been instrumental in significant medical breakthroughs, including the development of the UK polio vaccine and ultrasound scanning in pregnancy. Today, we continue to find and fund the very best medical research to help stop the suffering of babies and children caused by disease and disability. We want to make a difference in:
- tackling premature birth and treating sick and vulnerable babies
- helping children affected by disability, disabling conditions and infections
- targeting rare diseases that together severely affect many forgotten children.
Number of births for England and Wales is 708,711 see http://www.statistics.gov.uk/downloads/theme_population/FM1-37/FM1_37_2008.pdf and for Northern Ireland, 29,410 births see http://www.nisra.gov.uk/archive/demography/publications/annual_reports/2009/Chapter1.pdf
and for Wales 60,041, see table 3.8 http://www.gro-scotland.gov.uk/statistics/theme/vital-events/general/ref-tables/2008/section-3-births.html TOTAL= just under 800,000 live births for the UK
Gestation length for England see http://www.hesonline.nhs.uk/Ease/servlet/ContentServer?siteID=1937&categoryID=1475
Number of births pre 37 weeks = 66,355 = 8.29% rate of premature birth or just over 8% or 1 in 12 (have assumed the same incidence of premature birth across the UK)
[ii]Alcock J, Warren AY, Goodson YJ, Hill SJ, Khan RN, Lymn JS. Biol Reprod. 2010 Dec 1. Inhibition of Tissue Transglutaminase 2 Attenuates Contractility of Pregnant Human Myometrium.
[iii]Costeloe K, et al. The EPICure study: outcomes to discharge from hospital for infants born at the threshold of viability. Pediatrics 2000:106(4):659-71.
[iv]Summary of EPICure2 findings in latest EPICure newsletter on website: http://www.epicure.ac.uk/parents-newsletters/december-20102