The placenta is the nexus between the fetus and mother; placental health is absolutely central and critical to both fetal and maternal health. The placenta is the source of nutrition and oxygenation for the fetus, allows the fetus to eliminate waste, protects it from toxins, environmental exposures, infectious agents and rejection by the maternal immune system, and produces hormones that support the pregnancy. Abnormalities in placental structure and function underlie complications associated with pregnancy, including preterm birth, miscarriage and stillbirth, and hypertensive disorders such as preeclampsia. Therefore, monitoring placental function is necessary in order to prevent adverse outcomes for the mother and the fetus. Early detection of changes in placental function provides the opportunity for increased pregnancy surveillance and treatment. As is the case with every other organ, the functional state of the placenta is reflected by changes in the expression of coding and non-coding genes. Thus, monitoring the transcriptome of the placenta allows for a comprehensive assessment of placental function. The challenge is to be able to assess placental transcriptome without using invasive methods (e.g. placental biopsy) because these methods pose a risk to the pregnancy. To be clinically relevant, this method must be robust, reliable and able to use on large numbers of clinical samples at reasonable costs, and be able to monitor the full placental transcriptome. Unfortunately, these goals are not possible with existing technology. Our laboratory has developed an RNA sequencing method to comprehensively and quantitatively profile extracellular RNA (exRNA), specifically, placental microRNAs (miRNAs), found in maternal circulation. In the proposed project, we will advance this method and develop technology that will enable non-invasive monitoring of the placental transcriptome through the maternal blood and urine.
In Aim 1, we will develop two new technologies, automated exRNA Isolation (AxRI) and total short RNA sequencing (tsRNAseq) that will enable isolation and sequencing of coding and non-coding exRNAs from the maternal blood and urine.
In Aim 2, we will apply these new technologies to monitor placenta-specific exRNAs in the maternal blood and urine of term and first and second trimester pregnancies; these earlier time points are important because these is the gestational ages when changes in the transcriptome will be the most clinically relevant and biologically informative.
In Aim 3, we will define the precise cell-origin of placenta-specific exRNAs to provide contextual information to analysis of the exRNAs. Therefore, the scope of this project provides the unprecedented opportunity to leverage cutting-edge technologies for exRNA isolation and detection, sequencing, and bioinformatics, in order to develop a tool to non-invasively monitor the transcriptome of the placenta in real time. This tool can then be used to gain insights into pathogenesis of pregnancy-related diseases, identify high-risk pregnancies before the onset of end-organ damage and, ultimately, provide therapeutic interventions to improve maternal and neonatal health.

Public Health Relevance

A healthy pregnancy for the mother and fetus depends on proper functioning of the placenta; pregnancy complications - such as preterm birth, preeclampsia miscarriage and stillbirth - can result from abnormal placental function. The goal of this project is to develop a tool that will enable researchers and clinicians to monitor the function of the placenta through a test that will look at gene expression in the placenta by measuring RNAs that are released from the placenta and enter the mother's blood and urine. This tool can then be used to gain insights into pathogenesis of pregnancy-related diseases, identify high-risk pregnancies before the onset of end-organ damage and, ultimately, provide therapeutic interventions to improve maternal and neonatal health.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
1R01HD086327-01
Application #
9019743
Study Section
Special Emphasis Panel (ZHD1-DSR-Z (51))
Program Officer
Weinberg, David H
Project Start
2015-09-17
Project End
2020-05-31
Budget Start
2015-09-17
Budget End
2016-05-31
Support Year
1
Fiscal Year
2015
Total Cost
$808,512
Indirect Cost
$138,143
Name
Albert Einstein College of Medicine
Department
Obstetrics & Gynecology
Type
Schools of Medicine
DUNS #
110521739
City
Bronx
State
NY
Country
United States
Zip Code
10461
Wei, Shan; Weiss, Zachary R; Gaur, Pallavi et al. (2018) Rapid preimplantation genetic screening using a handheld, nanopore-based DNA sequencer. Fertil Steril 110:910-916.e2
Max, Klaas E A; Bertram, Karl; Akat, Kemal Marc et al. (2018) Human plasma and serum extracellular small RNA reference profiles and their clinical utility. Proc Natl Acad Sci U S A 115:E5334-E5343
Suryawanshi, Hemant; Morozov, Pavel; Straus, Alexander et al. (2018) A single-cell survey of the human first-trimester placenta and decidua. Sci Adv 4:eaau4788
Wei, Shan; Williams, Zev (2016) Rapid Short-Read Sequencing and Aneuploidy Detection Using MinION Nanopore Technology. Genetics 202:37-44