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Dario Fauza's research is directed at developing original, more effective ways to repair birth defects, both pre and postnatally. To that end, he has pioneered and explored a variety of approaches.
One is fetal tissue engineering, or the use of fetal cells to produce tissue to repair congenital anomalies. This concept involves the minimally invasive harvest of fetal cells, which are then employed to engineer tissue in the laboratory while pregnancy is allowed to continue, so that a newborn, or a fetus with a prenatally diagnosed birth defect can benefit from having autologous, expanded tissue readily available for surgical reconstruction, either before or after birth. Fetal cells can be obtained from the fetus itself, the amniotic fluid, the placenta, or umbilical cord blood. This concept has already been applied successfully, in large animal models, for the creation of various types of fetal tissue used in the treatment of several anomalies, including congenital diaphragmatic hernia, tracheal and chest wall defects, bladder extrophy, and cardiac anomalies. Related projects for the treatment of other birth defects are also ongoing. The first human application of this new therapeutic concept is expected before long, as regulatory hurdles are currently being addressed.
Another project is aimed at studying the immunological characteristics of fetal cells. Early results point to the fact that some of these cells are immunologically privileged, thus bettering their chances of engraftment after transplantation among different individuals. This may have many implications both in fetal tissue engineering and other fetal cell therapy applications.
Yet another area of interest to Dr. Fauza is the treatment of spina bifida. He has demonstrated that neural stem cells can partially repair damaged areas of the spinal cord in a large animal model of spina bifida, which could lead to improved outcomes in the treatment of this devastating disease. He is now perfecting the methods for isolation of neural stem cells and their delivery to the fetus or newborn, before human trials can be pursued.
He is also developing a novel method to facilitate clinical application of fetal tracheal occlusion as a means to treat lung hypoplasia (i.e. underdevelopment) associated with congenital diaphragmatic hernia. He has shown that fetal tracheal occlusion can be enhanced by intrapulmonary delivery of concentrated albumin, a protein that naturally occurs in the fetal lung liquid. The increased oncotic pressure in the fetal airway resulting from this intervention leads to an active expansion of fetal lung liquid. This, in turn, allows for fetal tracheal occlusion to become effective in the short term, late in gestation, thus avoiding prematurity, ever so prevalent with the current therapeutic methodology. This should lead to improved outcomes in this form of fetal treatment.
Finally, Dr. Fauza seeks to improve the safety of fetal surgery in general by studying fetal physiology during this form of intervention and by creating novel methods to prevent postoperative premature delivery. He has shown, experimentally, that direct local drug delivery to the uterus, rather than drug administration through the mother's blood stream, is a highly effective approach to control this dreadful and universal complication of fetal surgery. Among the drugs being tested for local administration to the uterus, Botox, which is known to inhibit muscular contractions, is among the most promising.
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