Fetal membranes can repair themselves after injury, researchers have found.
Scientists from Queen Mary University of London and UCL, with international colleagues, have found that myofibroblasts (MFs), which play an important role in wound healing, produce collagen before going on to repair a wound.
Fetal membranes can become damaged following infection, bleeding, after fetal surgery and following diagnostic test such as amniocentesis.
Because there are no clinical approaches available to repair or improve healing in the fetal membranes, and it is unclear if small holes in the membranes were able to heal themselves, the research team created small defects using a needle in donated human fetal membrane tissue, to mimic damage caused during fetal surgery.
The team, which included scientists from Nanyang Technological University, Singapore, and University Hospitals Leuven, Belgium, discovered that MFs crawled towards the edges of the wound and into the defect site before producing collagen and pulling the edges of the wound. This led to tissues being contracted together and then repaired.
These findings, reported in Scientific Reports, build on the team’s previous work that highlighted the importance the protein Connexin 43 (Cx43) in the process of wound healing and repair.
Dr Tina Chowdhury, senior lecturer in regenerative medicine at Queen Mary, said: “We have always thought that small diameter wounds created in human fetal membranes rarely heal by themselves but here we show that the tissues have the potential to do this.
“We found that Cx43 has different effects on cell populations found in the membranes and promotes transformation of AMCs into MFs, triggering them to move, repair and heal defects in the fetal membranes.”
They add that successful repair of fetal membranes could help to reduce the risk of preterm prelabour rupture of the membranes (PPROM), a major cause of preterm birth that accounts for about 40% of early infant death.
Anna David, UCLH consultant and professor in obstetrics and maternal fetal medicine and director at the UCL Elizabeth Garrett Anderson Institute for Women’s Health and a co-author of the study, said: “Finding that the fetal membranes have this potential to heal is a huge step towards developing treatments for women with PPROM. It holds out hope that we may be able to delay or even prevent preterm birth, which will significantly improve baby outcomes.”
Costa E, Okesola BO, Thrasivoulou C et al. Cx43 mediates changes in myofibroblast contraction and collagen release in human amniotic membrane defects after trauma. Scientific Reports 19 August 2021
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