In utero intervention to prevent adverse metabolic health - PROJECT SUMMARY Non-Communicable Diseases (NCDs), including cardiovascular disease, hypertension, central obesity, type 2 diabetes mellitus and respiratory disease, are responsible for 80% of adult deaths annually, and are responsible for having the greatest impact on health adjusted life expectancy and quality of life. Fetal growth restriction (FGR; estimated fetal weight <10th percentile), which occurs in up to 10% of pregnancies, is associated with increased risk of developing NCDs later in life. This is potentially because FGR results in developmental programming of fetal tissues and organs in order to adapt to the adverse conditions resulting in FGR, which persist into adulthood but ultimately predispose physiological and metabolic dysfunction. We have developed the use of a polymer-based, nanoparticle that facilitates non-viral gene delivery specifically to the placenta. Our placenta-specific, nanoparticle gene therapy is capable of increasing expression of human insulin-like growth factor 1 (hIGF1) in multiple animal and human placenta models. Importantly, our nanoparticle gene therapy is proven to be safe to both mother and fetus. We have consistently demonstrated that treatment increases placental glucose and amino acid transporter, and growth factor expression in diverse models of FGR (surgically-induced, genomic manipulation, maternal nutrient restriction (MNR)) because IGF1 is central to most mechanisms responsible for FGR associated with placental dysfunction, and a major regulator of placental and fetal growth and development. This proposal aims to 1) determine the impact of placental nanoparticle gene therapy treatment on developmental programming in fetal liver and kidney in late pregnancy, in the proven guinea pig MNR model of FGR, 2) Identify the mechanisms by which manipulating placenta signaling with nanoparticle gene therapy affect communication with fetal liver and kidney cells in human cell culture models, and 3) investigate the long-term impact of placenta-specific nanoparticle gene therapy on offspring liver and kidney physiology and metabolic health. Preliminary investigations confirm that placenta-specific, nanoparticle gene therapy increased fetal weight in preexisting FGR using the guinea pig MNR model. Furthermore, short-term placenta-specific nanoparticle gene therapy normalizes changes associated with FGR in fetal liver gene expression and kidney collagen deposition, hereby establishing a model in which further investigations into developmental programming of fetal organs can be investigated. This proposal is innovative and significant as it utilizes a nanoparticle technology currently being trialed in the treatment of cancer, but in the setting of reproductive medicine, thus generating knowledge that will inform clinical innovation in order to set the foundation for a healthy pregnancy and lifelong wellness.
