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.
About Dario Fauza
Dario Fauza received an MD from the University of Sao Paulo Medical
School, Brazil, where he also received a PhD-equivalent degree and
completed an internship and residencies on both general and pediatric
surgery at its Hospital of Clinics. He then moved to the United States,
where he completed different clinical and research fellowships, as well
as postdoctoral training, at Boston Children's Hospital.
He is the recipient of a number of research and funding grant awards,
both in his native country and in the US, as well as of a Fellowship ad
eundem (i.e. by invitation) by the Royal College of Surgeons of England
the first surgeon from his home country to receive such an honor. He
has an extensive bibliography and has been awarded different patents for
the development of novel surgical devices.