Transamniotic stem cell therapy: a novel strategy for the prenatal management of congenital anomalies

Abstract

Transamniotic stem cell therapy, or TRASCET, is an emerging therapeutic concept for the management of congenital anomalies based on the augmentation of the biological role of select populations of stem cells that already occur in the amniotic fluid, for targeted therapeutic benefit. Amniotic fluid-derived mesenchymal stem cells (afMSCs) have a central role in the enhanced ability of the fetus to repair tissue damage. This germane recent finding constitutes the biological foundation for the use of afMSCs in TRASCET. It has been shown experimentally that simple intra-amniotic delivery of afMSCs in large numbers can either elicit the repair, or significantly mitigate the effects associated with major congenital anomalies by boosting the activity that these cells normally have. For example, TRASCET can induce partial or complete coverage of experimental spina bifida by promoting the local formation of host-derived skin, thus protecting the spinal cord from further damage. In another example, it can significantly alleviate the bowel damage associated with gastroschisis, one of the most common major abdominal wall defects. Other applications involving different congenital anomalies and/or other stem cells present in the amniotic fluid in diseased pregnancies are currently under investigation in this freshly evolving facet of fetal stem cell therapy.

Initial Mechanistic Screening of Transamniotic Stem Cell Therapy in the Rodent Model of Spina Bifida: Host Bone Marrow and Paracrine Activity

“…Transamniotic stem cell therapy (TRASCET) has emerged experimentally as a novel alternative for the prenatal management of diverse congenital anomalies [1]. Such broad applicability is thought to be related to the fact that the donor cell most commonly used for TRASCET, the amniotic fluid-derived mesenchymal stem cell (afMSC), has been shown to play a central role in the fetus' ability to repair tissue damage [2].…”

Abdominal wall defects

“…The newest approach to prenatal gastroschisis coverage involves the use of mesenchymal stem cells. This technique is termed transamniotic stem cell therapy, or TRASCET (37). The theory behind TRASCET is that through augmentation of the biologic role of native stem cells within the amniotic fluid, targeted tissue repair can be achieved.…”

“…The theory behind TRASCET is that through augmentation of the biologic role of native stem cells within the amniotic fluid, targeted tissue repair can be achieved. Intra-amniotic delivery of amniotic fluid-derived mesenchymal stem cells (afMSCs) has been demonstrated to successfully induce partial or complete coverage of experimental myelomeningocele defects (37). The same theoretical benefit is now being explored for gastroschisis defects as well, with early results demonstrating sitespecific homing of afMSCs to areas of intestine exclusively exposed to amniotic fluid following TRASCET (38).…”

Transamniotic Stem Cell Therapy for Experimental Congenital Diaphragmatic Hernia: Structural, Transcriptional, and Cell Kinetics Analyses in the Nitrofen Model

“…Transamniotic stem cell therapy (TRASCET), specifically the direct intra-amniotic administration of large amounts of select fetal-derived mesenchymal stem cells (MSCs), has emerged experimentally as a promising adjuvant strategy in the prenatal management of different congenital anomalies that require surgical repair soon after birth, including gastroschisis, spina bifida, and possibly others [1]. The surprisingly varied beneficial effects and potential applications of TRASCET are thought to be derived from the amplification of the native biological role of donor MSCs, which have been shown to partake in innate fetal tissue repair processes [2].…”